MAYARA LONGUI CABRINI
Projetos de Pesquisa
Unidades Organizacionais
LIM/63, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
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- Obstructive sleep apnea and hypertension-mediated organ damage in nonresistant and resistant hypertension(2023) CABRINI, Mayara L.; MACEDO, Thiago A.; CASTRO, Emerson; BARROS, Silvana de; AZAM, Indira; PIO-ABREU, Andrea; SILVA, Giovanio V.; LORENZI-FILHO, Geraldo; BORTOLOTTO, Luiz A.; DRAGER, Luciano F.The potential role of obstructive sleep apnea (OSA) in hypertension-mediated organ damage (HMOD) may be influenced by the presence of resistant hypertension (RH). Herein, we enrolled patients with hypertension from a tertiary center for clinical evaluation and performed a sleep study to identify OSA (apnea-hypopnea index >= 15 events/h) and a blinded analysis of four standard HMOD parameters (left ventricular hypertrophy [LVH], increased arterial stiffness [>= 10 m/s], presence of retinopathy, and nephropathy). RH was diagnosed based on uncontrolled blood pressure (BP) (>= 140/90 mmHg) despite concurrent use of at least three antihypertensive drug classes or controlled BP with concurrent use of >= 4 antihypertensive drug classes at optimal doses. To avoid the white-coat effect, ambulatory BP monitoring was performed to confirm RH diagnosis. One-hundred patients were included in the analysis (mean age: 54 +/- 8 years, 65% females, body mass index: 30.4 +/- 4.5 kg/m(2)). OSA was detected in 52% of patients. Among patients with non-RH (n = 53), the presence of OSA (52.8%) was not associated with an increased frequency of HMOD. Conversely, among patients with RH, OSA (51.1%) was associated with a higher incidence of LVH (RH-OSA,61%; RH + OSA,87%; p = 0.049). Logistic regression analysis using the total sample revealed that RH (OR:7.89; 95% CI:2.18-28.52; p = 0.002), systolic BP (OR:1.04; 95% CI:1.00-1.07; p = 0.042) and OSA (OR:4.31; 95% CI:1.14-16.34; p = 0.032) were independently associated with LVH. No significant association was observed between OSA and arterial stiffness, retinopathy, or nephropathy. In conclusion, OSA is independently associated with LVH in RH, suggesting a potential role of OSA in RH prognosis.
- Effect of CPAP treatment on BP in resistant hypertensive patients according to the BP dipping pattern and the presence of nocturnal hypertension(2022) SAPINA-BELTRAN, Esther; BENITEZ, Ivan D.; TORRES, Gerard; FORTUNA-GUTIERREZ, Ana M.; MARQUEZ, Paola Ponte; MASA, Juan F.; DRAGER, Luciano F.; CABRINI, Mayara; FELEZ, Miquel; VAZQUEZ, Susana; ABAD, Jorge; LEE, Ch; GARCIA-RIO, Francisco; CASITAS, Raquel; MEDIANO, Olga; PERALTA, Sofia Romero; MARTINEZ, Dolores; SANCHEZ-DE-LA-TORRE, Manuel; BARBE, Ferran; DALMASES, MireiaHigh heterogeneity in the blood pressure (BP) response to continuous positive airway pressure (CPAP) exists in patients with resistant hypertension (RH). Only nondipper normotensive and hypertensive patients exhibited BP reductions when treated with CPAP; the baseline BP dipping pattern has been proposed as a predictor of BP response to CPAP but has never been explored in patients with RH. This study aimed to assess the effect of CPAP on BP in subjects with RH with respect to BP dipping pattern or nocturnal hypertension. This is an ancillary study of the SARAH study. RH subjects with an apnea/hypopnea index (AHI) >= 15/h and who received CPAP treatment for 1 year were included. Subjects underwent a sleep study and ambulatory BP monitoring (ABPM) at baseline and at the 1-year follow-up. Eighty-nine RH subjects were included. The subjects were mainly male (77.5%) and obese, with a mean age of 66 years (25th-75th percentile; 59.0; 70.0) and an AHI of 32.7/h (25th-75th percentile; 25.0; 54.7). A total of 68.5% of participants were nondippers, and 71.9% had nocturnal hypertension. After 1 year of CPAP, no significant differences in ABPM parameters were observed between dippers and nondippers. According to nighttime BP, subjects with nocturnal normotension did not show significant changes in ABPM parameters, while nocturnal hypertensive subjects achieved a significant reduction in mean nighttime BP of -4.38 mmHg (-7.10 to -1.66). The adjusted difference between groups was 3.04 (-2.25 to 8.34), which was not significant. This study shows that the BP response to CPAP in patients with RH does not differ according to the BP dipping pattern (dipper and nondipper) and suggests a differential response according to the presence of nocturnal hypertension.
- Prevalence, Characteristics, and Association of Obstructive Sleep Apnea with Blood Pressure Control in Patients with Resistant Hypertension(2019) SAPINA-BELTRAN, Esther; TORRES, Gerard; BENITEZ, Ivan; FORTUNA-GUTIERREZ, Ana Maria; MARQUEZ, Paola Ponte; MASA, Juan Fernando; CORRAL-PENAFIEL, Jaime; DRAGER, Luciano F.; CABRINI, Mayara; FELEZ, Miguel; VAZQUEZ, Susana; ABAD, Jorge; LEE, Chi-Hang; AUNG, Aye Thandar; GARCIA-RIO, Francisco; CASITAS, Raquel; SANCHEZ-DE-LA-TORRE, Manuel; GAETA, Anna Michela; BARBE, Ferran; DALMASES, MireiaRationale: Obstructive sleep apnea (OSA) is associated with poor blood pressure (BP) control and resistant hypertension (RH). Nevertheless, studies assessing its prevalence, characteristics, and association with BP control in patients with RH are limited. Objectives: The aim of this multicenter study was to assess the prevalence of OSA in a large cohort of subjects with RH and to evaluate the association of OSA with BP control. Methods: We recruited consecutive subjects with RH from three countries. A formal sleep test and blood pressure measurements, including 24-hour ambulatory blood pressure monitoring, were performed in all participants. Results: In total, 284 subjects with RH were included in the final analysis. Of these, 83.5% (95% confidence interval [CI], 78.7-87.3%) had OSA (apnea-hypopnea index >= 5 events/h); 31.7% (95% CI 26.5-37.3%) had mild OSA, 25.7% (95% CI, 21-31.1%) had moderate OSA, and 26.1% (95% CI, 21.3-31.5%) had severe OSA. Patients with severe OSA had higher BP values than subjects with mild to moderate or no OSA. A greater effect was observed on the average nighttime BP, with an adjusted effect of 5.72 mm Hg (95% CI, 1.08-10.35 mm Hg) in severe OSA compared with participants without OSA. A dose-response association between the severity of OSA and BP values was observed. The prevalence of severe OSA was slightly higher in uncontrolled participants (adjusted odds ratio, 1.69; 95% CI, 0.97-2.99) but was not statistically significant. Conclusions: The present study confirms the high prevalence of OSA in participants with RH. Furthermore, it shows a dose-response association between OSA severity and BP measurements, especially in the nighttime.
conferenceObject Obstructive sleep apnea is associated with higher left ventricle hypertrophy frequency in patients with resistant hypertension(2020) CABRINI, Mayara Longui; MACEDO, Thiago A.; DEBARROS, Silvana; AZAM, Indira F. B.; PIO-ABREU, Andrea; SILVA, Giovanio V.; BORTOLOTTO, Luiz A.; LUCIANO, Luciano F.conferenceObject OBSTRUCTIVE SLEEP APNEA IS ASSOCIATED WITH HIGHER LEFT VENTRICLE HYPERTROPHY FREQUENCY IN PATIENTS WITH RESISTANT HYPERTENSION(2019) CABRINI, M. L.; MACEDO, T. A.; BARROS, S. de; AZAM, I. F. B.; PIO-ABREU, A.; SILVA, G. V.; LORENZI-FILHO, G.; BORTOLOTTO, L. A.; DRAGER, L. F.