We surveyed patients with refractory hypertension in a primary care setting and assessed their risk of having obstructive sleep apnea (OSA).
We utilized the Berlin Questionnaire to survey 134 sequential patients with refractory hypertension. As with the original Berlin Questionnaire's stratification scheme, patients were placed into a high risk or low risk group for OSA. Patients with refractory hypertension were defined as those prescribed two antihypertensive medications with concomitant blood pressures above 140/90 or on three or more antihypertensive drugs. Patients were surveyed by medical staff prior to their appointments in an urban primary care clinic in Kansas City, Missouri. The University of Missouri Kansas City IRB approved this study after a full review.
Of the 134 sequential patients surveyed, we identified 92 patients who were at high risk for OSA (68% of the patients surveyed). Of those 92 patients, 70% (95% CI: 60.1% and 75.9%) had never been scheduled for nor had a sleep study done. Of the 42 patients who were found to be at low risk for OSA, 6 had been scheduled for a sleep study.
At this urban clinic in Kansas City, Missouri, patients with refractory hypertension were not being routinely screened for OSA. Use of a validated screening tool such as the Berlin Questionnaire might allow clinicians to recognize those patients at risk and determine if a sleep study is warranted.
This project has propagated future studies to determine the best way to implement standardized screening methods for identification of concomitant OSA in patients with refractory hypertension.
James Ladesich, No Financial Disclosure Information; No Product/Research Disclosure Information