Jacek Wolf1, Jacek Drozdowski2, Krzysztof Czechowicz3, Paweł J Winklewski4, Ewa Jassem2, Tomas Kara5, Virend K Somers6, Krzysztof Narkiewicz3. 1. Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland; Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital in Brno (FNUSA), Brno, Czech Republic. Electronic address: lupus@gumed.edu.pl. 2. Department of Pneumonology and Allergology, Medical University of Gdańsk, Gdańsk, Poland. 3. Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland. 4. Institute of Human Physiology, Medical University of Gdańsk, Gdańsk, Poland. 5. Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital in Brno (FNUSA), Brno, Czech Republic; Divisions of Cardiovascular Diseases and Hypertension, Mayo Clinic, Rochester, MN, USA; Department of Cardiology, University Hospital Olomouc, Czech Republic. 6. Divisions of Cardiovascular Diseases and Hypertension, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: Beta1-receptor antagonists (BBs) are commonly administered in the treatment of cardiovascular disease (CVD). The reported benefits of BB use in CVD patients with concomitant obstructive sleep apnea (OSA) may be limited by their impact on apnea-induced bradycardias. Therefore the aim of the study was to test the influence of BBs on periapneic heart rate (HR) fluctuations in hypertensive patients with newly-detected and untreated OSA. METHODS: We studied 88 hypertensive patients (56 on BBs and 32 BB naive) with newly-diagnosed moderate-to-severe OSA who were free of major pulmonary comorbidities and did not require antiarrhythmic therapy. ECGs recorded during sleep were investigated for heart rate (HR) responses to apneas allowing to compare extreme HR accelerations and decelerations between the groups. RESULTS: Average sleep-time HR was comparable in BB-naive (BB-) and BB-treated (BB+) patients. Direct comparisons showed that HR decelerations were also similar in the two subgroups (53.8±9.6 vs. 54.4±7.8 bpm; P=0.78, for BB- and BB+, respectively) however, BBs blunted the OSA-induced HR accelerations (82.3±12.2 vs. 74.3±10.0; P=0.003). After adjusting for baseline HR and magnitude of desaturations, HR decelerations were more evident in BB-naive group whereas tachycardic responses remained blunted in the BB+ group. The incidence of ectopies and conduction abnormalities were comparable across two groups. CONCLUSIONS: Beta-blockers do not potentiate apnea-induced HR decelerations, attenuate apnea-induced increases in heart rate and do not influence incidence of ectopies and conduction abnormalities in patients with hypertension and moderate-to-severe, untreated OSA.
BACKGROUND: Beta1-receptor antagonists (BBs) are commonly administered in the treatment of cardiovascular disease (CVD). The reported benefits of BB use in CVD patients with concomitant obstructive sleep apnea (OSA) may be limited by their impact on apnea-induced bradycardias. Therefore the aim of the study was to test the influence of BBs on periapneic heart rate (HR) fluctuations in hypertensivepatients with newly-detected and untreated OSA. METHODS: We studied 88 hypertensivepatients (56 on BBs and 32 BB naive) with newly-diagnosed moderate-to-severe OSA who were free of major pulmonary comorbidities and did not require antiarrhythmic therapy. ECGs recorded during sleep were investigated for heart rate (HR) responses to apneas allowing to compare extreme HR accelerations and decelerations between the groups. RESULTS: Average sleep-time HR was comparable in BB-naive (BB-) and BB-treated (BB+) patients. Direct comparisons showed that HR decelerations were also similar in the two subgroups (53.8±9.6 vs. 54.4±7.8 bpm; P=0.78, for BB- and BB+, respectively) however, BBs blunted the OSA-induced HR accelerations (82.3±12.2 vs. 74.3±10.0; P=0.003). After adjusting for baseline HR and magnitude of desaturations, HR decelerations were more evident in BB-naive group whereas tachycardic responses remained blunted in the BB+ group. The incidence of ectopies and conduction abnormalities were comparable across two groups. CONCLUSIONS: Beta-blockers do not potentiate apnea-induced HR decelerations, attenuate apnea-induced increases in heart rate and do not influence incidence of ectopies and conduction abnormalities in patients with hypertension and moderate-to-severe, untreated OSA.
Authors: Michael A Weber; George L Bakris; Björn Dahlöf; Bertram Pitt; Eric Velazquez; Jitendra Gupte; Martin Lefkowitz; Allen Hester; Victor Shi; Matthew Weir; Sverre Kjeldsen; Barry Massie; Shawna Nesbitt; Elizabeth Ofili; Kenneth Jamerson Journal: Blood Press Date: 2007 Impact factor: 2.835
Authors: Magdalena Wszedybyl-Winklewska; Jacek Wolf; Ewa Swierblewska; Katarzyna Kunicka; Agnieszka Gruszecka; Marcin Gruszecki; Wieslawa Kucharska; Pawel J Winklewski; Joanna Zabulewicz; Wojciech Guminski; Michal Pietrewicz; Andrzej F Frydrychowski; Leszek Bieniaszewski; Krzysztof Narkiewicz Journal: PLoS One Date: 2017-02-27 Impact factor: 3.240