SHORT-TERM ANTIHYPERTENSIVE MEDICATION DOES NOT EXACERBATE SLEEP-DISORDERED BREATHING IN NEWLY-DIAGNOSED HYPERTENSIVE PATIENTS

It has been speculated for some time that various antihypertensive med ications may have a deleterious effect on respiration during sleep and thereby enhance the apparent association between hypertension and sle ep apnea/hypopnea (SAH). However, there are few data to support this c ontention. The present study used a double-blind, randomized, cross-ov er design to contrast the effects of 6 weeks treatment with alpha-meth yldopa and the combination of hydrochlorothiazide and amiloride with t hat of amlodipine and the combined diuretics in a group of 24 newly di agnosed patients with primary hypertension. All-night polysomnography was performed before the initiation of therapy (baseline) and at the e nd of the two treatment periods. Respiratory variables failed to revea l any significant differences between the treatments and baseline, or between the two different treatment regimens. The two treatment regime ns achieved similar reductions in blood pressure. The prevalence of SA H was 25% before treatment, which is comparable to a prevalence of 20% in a similar group drawn from the same population but receiving vario us antihypertensive medications. The findings of this study are in agr eement with previous reports using other classes of antihypertensive d rugs that also failed to detect any tendency for increases in nocturna l respiratory disturbance indices over assessment periods of 8 weeks o r shorter. (C) 1997 American journal of Hypertension, Ltd.