Effects of antihypertensive treatment on left and right ventricular global longitudinal strain and diastolic parameters in patients with hypertension and obstructive sleep apnea : randomized clinical trial of chlorthalidone plus amiloride vs. amlodipine

• Autor(a) principal: Jorge, Juliano Afonsino
• Data de Publicação: 2023
• Outros Autores: Foppa, Murilo, Santos, Ângela Barreto Santiago, Cichelero, Fábio Tremea, Martinez, Denis, Lucca, Marcelo Balbinot, Oliveira, Geórgia Pante Fagundes de, Fuchs, Flávio Danni, Fuchs, Sandra Cristina Pereira Costa
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/265555
• topic: Hipertensão; Apneia obstrutiva do sono; Eletrocardiografia; Terapêutica; Tratamento farmacológico; Disfunção ventricular esquerda; Deformação longitudinal global; Ventrículos do coração; Ensaio clínico controlado aleatório; Diastolic function; Global longitudinal strain; Left ventricular; Randomized controlled trial; Obstructive sleep apnea; Hypertension; Echocardiography

Hypertension is highly prevalent in patients with obstructive sleep apnea (OSA), and fluid retention with its nighttime rostral distribution is one potential mechanism. We tested whether or not diuretics differ from amlodipine in their impact on echocardiographic parameters. Patients with moderate OSA and hypertension were randomized to receive diuretics (chlorthalidone plus amiloride) or amlodipine daily for 8 weeks. We compared their effects on left and right ventricular global longitudinal strain (LV-GLS and RV-GLS, respectively), on LV diastolic parameters, and on LV remodeling. In the 55 participants who had echocardiographic images feasible for strain analysis, all echocardiographic parameters were within normal ranges. After 8 weeks, the 24 h blood pressure (BP) reduction values were similar, while most echocardiographic metrics were kept unchanged, except for LV-GLS and LV mass. In conclusion, the use of diuretics or amlodipine had small and similar effects on echocardiographic parameters in patients with moderate OSA and hypertension, suggesting that they do not have important effects on mediating the interaction between OSA and hypertension.