LB063 - METABOLIC COMORBIDITIES IN PATIENTS WITH NOCTURNAL HYPERTENSION AND SLEEP APNEA IN PRIMARY CARE: BASELINE RESULTS FROM THE METASLEEP STUDY
LB063
METABOLIC COMORBIDITIES IN PATIENTS WITH NOCTURNAL HYPERTENSION AND SLEEP APNEA IN PRIMARY CARE: BASELINE RESULTS FROM THE METASLEEP STUDY
N. Bueno Hernández1,*, F. Roche-Campo2, I. Salvador-Adell2, Z. Hernández Rojas3,4, M. Ribes Pedret3, E. Castro Blanco1, E. Martí Solé3, M. Serra-Fortuny2, M. V. Maestro Ibáñez3, D. D. Montalvo Barrera3, J. M. Carrera Ortíz3, A. Queiroga Gonçalves1,5, N. Carrasco-Querol1, C. Aguilar Martín1,6, F. Barbé7,8 on behalf of On behalf of the METASLEEP Project
1Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 2Hospital de Tortosa Verge de la Cinta, 3Servei d'Atenció Primària Terres de l'Ebre, Institut Català de la Salut , Tortosa, 4Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 5Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Barcelona, 6Unitat d’Avaluació i Recerca, Direcció d’Atenció Primària Terres de l’Ebre i Gerència Territorial Terres de l’Ebre, Institut Català de la Salut (ICS), Tortosa, 7Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, 8CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
Rationale: Sleep apnea is associated with cardiovascular and metabolic alterations, including nocturnal hypertension and non-dipping blood pressure patterns. The METASLEEP project aims to study the impact of sleep-disordered breathing management in systemic hypertension control in a primary care setting.
Methods: A cross-sectional and descriptive study was conducted including 111 patients from the primary care setting of the METASLEEP project (South Catalonia node), all of whom presented with nocturnal hypertension and/or a non-dipper blood pressure profile assessed via 24-hour ambulatory blood pressure monitoring (ABPM). Afterwards sleep-disordered breathing was evaluated using the WatchPAT 300 home sleep test and classified by peripheral Apnea-Hypopnea Index (pAHI) into no or mild apnea (NMA, pAHI <15) and moderate-to-severe apnea (MSA, pAHI ≥15). We collected data on age, sex, income, BMI, neck circumference, Epworth Sleepiness Scale, tobacco and alcohol use, adherence to the Mediterranean diet (er-MEDAS 17-items), inflammatory marker (CRP), metabolic parameters (glucose, lipid profile, obesity, metabolic syndrome), and medication (lipid-lowering agents, insulin, oral antidiabetics). Results were statistically analyzed between apnea severity groups by Mann–Whitney U test and the Chi-square test.
Results: Among 111 patients, 31 (27.9%) were classified as NMA and 80 (72.1%) as MSA, with comparable mean ages (65 vs 64 years) (p=0.762) and sex distribution (48.4% vs 47.5% women) (p=1.000). The MSA group showed significantly higher BMI (31.77 vs 28.44 kg/m², p = 0.002) and a tendency toward greater neck circumference (p=0.080). MSA patients also reported higher alcohol consumption (p=0.273), lower adherence to the Mediterranean diet (82.4% vs 75.0%) (p=0.517), and were the only group with isolated non-dipper blood pressure (9.5%). Although not all were statistically significant, pathological daytime sleepiness (p=0.217), elevated glucose (p=0.102), and higher CRP (p=0.357) were more common in MSA. Use of lipid-lowering therapy (42.5% vs 38.7%) (p=0.882), insulin (8.8% vs 6.5%) (p=0.992), and oral antidiabetic agents (21.2% vs 12.9%) (p=0.461) was also higher in MSA. In the metabolic syndrome subgroup (n = 44), MSA patients presented more frequently with obesity (73.5% vs 40%), diabetes (26.5% vs 20%), dyslipidemia (26.5% vs 10%), and oral antidiabetic use (26.5% vs 10%).
Conclusion: Our findings highlight the need for integrated cardiometabolic screening and multidisciplinary care in patients with suspected sleep apnea. The clinical profile observed is consistent with syndrome Z, combining sleep-disordered breathing and metabolic syndrome. Follow-up at 6 months will assess whether CPAP improves metabolic and inflammatory parameters. Furthermore, a lifestyle intervention focused on increasing Mediterranean diet adherence, nutritional quality, thus reducing neck circumference, BMI and improving body composition, would optimize health outcomes.
Disclosure of Interest: None declared