The role of beta-blockers in combination antihypertensive therapy in patients with obstructive sleep apnea syndrome

Introduction. Obstructive sleep apnea syndrome (OSA) is a common cause of hypertension, driven by common pathogenetic mechanisms, primarily sympathetic hypertension. The use of beta-blockers (BB) is pathogenetically justified; however, the efficacy and safety of this treatment strategy require clarification.

Aim. To evaluate the efficacy and safety of BB in combination antihypertensive therapy in patients with OSA.

Materials and methods. The study included 109 men with hypertension (HTN), obesity, and OSA (apnea/hypopnea index > 15/hour). Participants had no baseline structural heart disease, diabetes, coronary artery disease, atherosclerosis of any location, or atrial fibrillation. All participants were divided into groups based on the chosen treatment strategy – beta-blocker therapy and continuous positive airway pressure therapy (CPAP). Following a three-year follow-up period, biochemical marker levels were re-evaluated, and the incidence of adverse clinical events was compared.

Results. A statistically significant increase in high-density lipoprotein (HDL) levels and a decrease in the METS-IR insulin resistance index were found in the groups receiving beta-blockers, while a statistically significant decrease in triglyceride levels was observed with a combination of beta-blockers and CPAP therapy. In the groups of patients not receiving beta-blockers, an increase in atherogenic fractions of total cholesterol and non-HDL cholesterol was noted. The incidence of adverse clinical outcomes did not differ significantly between the groups with different treatment strategies; however, the use of beta-blockers allowed a greater number of participants to achieve target blood pressure levels.

Conclusions. The study results demonstrate the high efficacy and safety of using beta-blockers as part of combination antihypertensive drug therapy in obese men with hypertension associated with OSA.

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