Effect of beta-blocker therapy on heart rate response in patients with hypertension and newly diagnosed untreated obstructive sleep apnea syndrome

Jacek Wolf, Jacek Drozdowski, Krzysztof Czechowicz, Paweł J. Winklewski, Ewa Jassem, Tomas Kara, Virend Somers, Krzysztof Narkiewicz

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Beta1-receptor antagonists (BBs) are commonly administered in the treatment of cardiovascular disease (CVD). The reported benefits of BB use in CVD patients with concomitant obstructive sleep apnea (OSA) may be limited by their impact on apnea-induced bradycardias. Therefore the aim of the study was to test the influence of BBs on periapneic heart rate (HR) fluctuations in hypertensive patients with newly-detected and untreated OSA. Methods: We studied 88 hypertensive patients (56 on BBs and 32 BB naive) with newly-diagnosed moderate-to-severe OSA who were free of major pulmonary comorbidities and did not require antiarrhythmic therapy. ECGs recorded during sleep were investigated for heart rate (HR) responses to apneas allowing to compare extreme HR accelerations and decelerations between the groups. Results: Average sleep-time HR was comparable in BB-naive (BB -) and BB-treated (BB +) patients. Direct comparisons showed that HR decelerations were also similar in the two subgroups (53.8 ± 9.6 vs. 54.4 ± 7.8 bpm; P = 0.78, for BB - and BB +, respectively) however, BBs blunted the OSA-induced HR accelerations (82.3 ± 12.2 vs. 74.3 ± 10.0; P = 0.003). After adjusting for baseline HR and magnitude of desaturations, HR decelerations were more evident in BB-naive group whereas tachycardic responses remained blunted in the BB + group. The incidence of ectopies and conduction abnormalities were comparable across two groups. Conclusions: Beta-blockers do not potentiate apnea-induced HR decelerations, attenuate apnea-induced increases in heart rate and do not influence incidence of ectopies and conduction abnormalities in patients with hypertension and moderate-to-severe, untreated OSA.

Original languageEnglish (US)
Pages (from-to)67-72
Number of pages6
JournalInternational Journal of Cardiology
Volume202
DOIs
StatePublished - Jan 1 2016

Fingerprint

Obstructive Sleep Apnea
Heart Rate
Hypertension
Deceleration
Apnea
Therapeutics
Sleep
Cardiovascular Diseases
Incidence
Bradycardia
Comorbidity
Electrocardiography
Lung

Keywords

  • Beta-blockers
  • Bradycardia
  • Heart rate control
  • Obstructive sleep apnea
  • Tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of beta-blocker therapy on heart rate response in patients with hypertension and newly diagnosed untreated obstructive sleep apnea syndrome. / Wolf, Jacek; Drozdowski, Jacek; Czechowicz, Krzysztof; Winklewski, Paweł J.; Jassem, Ewa; Kara, Tomas; Somers, Virend; Narkiewicz, Krzysztof.

In: International Journal of Cardiology, Vol. 202, 01.01.2016, p. 67-72.

Research output: Contribution to journalArticle

Wolf, Jacek ; Drozdowski, Jacek ; Czechowicz, Krzysztof ; Winklewski, Paweł J. ; Jassem, Ewa ; Kara, Tomas ; Somers, Virend ; Narkiewicz, Krzysztof. / Effect of beta-blocker therapy on heart rate response in patients with hypertension and newly diagnosed untreated obstructive sleep apnea syndrome. In: International Journal of Cardiology. 2016 ; Vol. 202. pp. 67-72.
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AU - Wolf, Jacek

AU - Drozdowski, Jacek

AU - Czechowicz, Krzysztof

AU - Winklewski, Paweł J.

AU - Jassem, Ewa

AU - Kara, Tomas

AU - Somers, Virend

AU - Narkiewicz, Krzysztof

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AB - Background: Beta1-receptor antagonists (BBs) are commonly administered in the treatment of cardiovascular disease (CVD). The reported benefits of BB use in CVD patients with concomitant obstructive sleep apnea (OSA) may be limited by their impact on apnea-induced bradycardias. Therefore the aim of the study was to test the influence of BBs on periapneic heart rate (HR) fluctuations in hypertensive patients with newly-detected and untreated OSA. Methods: We studied 88 hypertensive patients (56 on BBs and 32 BB naive) with newly-diagnosed moderate-to-severe OSA who were free of major pulmonary comorbidities and did not require antiarrhythmic therapy. ECGs recorded during sleep were investigated for heart rate (HR) responses to apneas allowing to compare extreme HR accelerations and decelerations between the groups. Results: Average sleep-time HR was comparable in BB-naive (BB -) and BB-treated (BB +) patients. Direct comparisons showed that HR decelerations were also similar in the two subgroups (53.8 ± 9.6 vs. 54.4 ± 7.8 bpm; P = 0.78, for BB - and BB +, respectively) however, BBs blunted the OSA-induced HR accelerations (82.3 ± 12.2 vs. 74.3 ± 10.0; P = 0.003). After adjusting for baseline HR and magnitude of desaturations, HR decelerations were more evident in BB-naive group whereas tachycardic responses remained blunted in the BB + group. The incidence of ectopies and conduction abnormalities were comparable across two groups. Conclusions: Beta-blockers do not potentiate apnea-induced HR decelerations, attenuate apnea-induced increases in heart rate and do not influence incidence of ectopies and conduction abnormalities in patients with hypertension and moderate-to-severe, untreated OSA.

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KW - Bradycardia

KW - Heart rate control

KW - Obstructive sleep apnea

KW - Tachycardia

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