Dados do Trabalho

Título

Does Insomnia impact blood pressure control in Patients with Hypertension?

Introdução

Insomnia is a sleep disorder characterized by difficulty in initiating or maintaining sleep, or waking up earlier than desired, despite having adequate opportunities for sleep. The prevalence of insomnia has been increasing worldwide, with reported rates ranging from 7% to 19% in adults. Recent evidence suggests that insomnia may play a role in the onset of hypertension (HTN), but its impact on patients with established HTN remains uncertain.

Objetivo

To evaluate blood pressure (BP) control in the office (considering BP <140/90 mmHg) in both groups. As secondary objectives, we assessed the groups concerning clinical characteristics, the number of antihypertensive medications used, and the percentage of apparent treatment-resistant hypertension (aTRH).

Métodos

Consecutive patients seen at the Hypertension Clinic of the Heart Institute (InCor), University of São Paulo, were evaluated. The patients were assessed through interviews; the application of validated questionnaires, and a clinical evaluation that included medical history, the number of antihypertensive medications used, comorbidities, collection of anthropometric data and standardized BP measurement (three measurements using a validated digital device, averaging the 2nd and 3rd measurements). The sample was analyzed, stratifying patients with and without insomnia.

Resultados

A total of 700 consecutive patients were evaluated (63.6% female, median age of 64 years, 46.8% with obesity, mean antihypertensive classes:4.3±1.5). Insomnia was present in 53% of the sample. The groups with (n=371) and without (n=329) insomnia were homogeneous concerning age and the presence of obesity. However, patients with insomnia had significantly more women (72.2% vs. 53.8%; p<0.001). Compared to patients without insomnia, those with insomnia presented similar rate of office BP control (29,9% vs. 31,3%, p=0.69). Similarly, the percentage of patients using ≥4 antihypertensives was similar between the groups (72% vs. 66.9%; p=0.143). The group with insomnia showed a trend toward a higher frequency of aTRH compared to patients without insomnia (72.5% vs. 66.3%; p=0.073).

Conclusões

Insomnia is highly prevalent among patients with HTN from a tertiary Cardiology center. These preliminary data show that the BP control rate was similar in groups with and without insomnia; however, a trend for a higher rate of aTRH in the insomnia group suggests a potential relevance of this sleep disorder in the context of HTN.

Palavras -chave

Insomnia, Hypertension