Blood pressure and lipid profi le changes in patientswith obstructive sleep apnea and metabolicsyndrome on combination treatment

Abstract

Objective. To evaluate efficiency of the combination treatment of arterial hypertension and dyslipidemia in patients with metabolic syndrome associated with obstructive sleep apnea syndrome. Design and methods. A total of 80 patients were examined. Anamnesis, anthropometric parameters, biochemical data were assessed by standard methods. Hypotensive response to the treatment was evaluated by office blood pressure measurement. Initially all patients had metabolic syndrome criteria (NCEP ATPIII). OSAS diagnosis was made based on cardiorespiratory monitoring (Breas SC20, Sweden) data. Antihypertensive therapy included Lyzinopril 10 mg per day at stage I, 20 mg per day at stage II and combination of Lyzinopril 20 mg per day and Indopamide 1,5 mg per day at stage III. At stage IV Bisoprolol 5 mg per day was added to the treatment. Duration of the treatment at each stage was 4 weeks. All patients received Symvastatin 20 mg per day. The follow-up was 2 years. Results. OSAS severity was positively associated with office blood pressure, blood lipids alteration and insulin resistance. Positive dynamics of BP and lipid spectrum was significantly lower in treated patients with severe OSAS than in patients with moderate and mild OSAS. Conclusion. Therapy resistance manifests with the increase of the severity of sleep breathing disorders.