Usage of antihypertensive drugs and benzodiazepines to estimate apnea/hypopnea index in arterial hypertension.

BACKGROUND

Sleep apnea is a very common condition, particularly in patients with arterial hypertension. A precise diagnosis, however, requires the performance of a sleep study. Clinical surrogate markers for significant apnea could be useful in guiding decisions to perform sleep studies.

METHODS

Sixty-three patients with treated arterial hypertension and body mass index (BMI) greater than 25, with a mean value of 30.7 +/- 3.7, were studied. The apnea/hypopnea index (AHI) obtained by sleep study was taken for further study, as were the values for blood pressure, BMI, and age. A combination drug score (DS) was calculated for each patient, with three different possible values: minus 1, zero, and plus one, based on the use of benzodiazepine drugs and on the number of anti-hypertensive drugs in use.

RESULTS

The use of the combination drug score yielded mean AHI values of 13.4 +/- 12.6 (episodes/hour sleep; n = 19) for a minus one score, 15.0 +/- 14.1 (n = 29) for a score of zero, and 29.0 +/- 20.1 (n = 15; p < 0.05 versus the other two groups) for a score of plus one (this latter group consisting of patients not taking benzodiazepines and taking three or more antit-hypertensive drugs).

CONCLUSIONS

In patients with arterial hypertension and excessive weight, sleep apnea magnitude may be associated with a combination drug score based on the use of antihypertensive drugs and benzodiazepines. The DS now described is simple to calculate and may be added to other clinical information when making decisions on whether to proceed to sleep study.