There is a close relationship between obstructive sleep apnoea (OSA) and resistant hypertension (RH). However, studies assessing the long-term effect of diagnosing and treating OSA on blood pressure (BP) control in these patients are lacking.

To address this gap, we recruited 478 RH patients from hypertension units and followed them prospectively after they were screened for OSA through a sleep study. By performing 24-h ambulatory BP monitoring (ABPM) annually, the effect of OSA management was assessed.

The patients had a median (interquartile range (IQR)) age of 64.0 (57.2–69.0) years, 67% were males and most were nonsleepy, with a median (IQR) apnoea–hypopnoea index (AHI) of 15.8 (7.9–30.7) events·h^–1. The median (IQR) follow-up time was 3.01 (2.93–3.12) years. At baseline, severe OSA was associated with uncontrolled BP, nocturnal hypertension and a nondipper circadian BP pattern. Moreover, these patients had higher BP values during follow-up than did patients in the other groups. However, among patients with moderate and severe OSA, the management of sleep disordered breathing, including the implementation of continuous positive airway pressure treatment, was associated with a reduction in 24-h ABPM parameters, especially night-time BP values, at the 1-year follow-up. These benefits were attenuated over time and only subjects with severe OSA maintained an ABPM night-time reduction at 3 years. Furthermore, clinical variables such as uncontrolled BP, sex and age showed a predictive value for the BP response at 1 year of follow-up.

A favourable long-term decrease in BP was detected by diagnosing and treating OSA in a cohort of RH patients from hypertension units, but over time this decrease was only partially maintained in severe OSA patients.

阻塞性睡眠呼吸暂停（OSA）和难治性高血压（RH）之间存在密切关系。然而，缺乏评估诊断和治疗 OSA 对这些患者血压 (BP) 控制的长期影响的研究。

为了弥补这一差距，我们从高血压病房招募了 478 名 RH 患者，并在通过睡眠研究筛查 OSA 后对他们进行前瞻性随访。通过每年进行 24 小时动态血压监测 (ABPM)，评估 OSA 管理的效果。

患者的中位年龄（四分位距 (IQR)）为 64.0 (57.2–69.0) 岁，其中 67% 为男性，大多数不嗜睡，中位 (IQR) 呼吸暂停低通气指数 (AHI) 为 15.8 (7.9–30.7) ) 事件·h ^–1 .中位随访时间 (IQR) 为 3.01 (2.93–3.12) 年。在基线时，严重的 OSA 与血压失控、夜间高血压和非杓状昼夜血压模式相关。此外，这些患者在随访期间的血压值高于其他组的患者。然而，在中度和重度 OSA 患者中，睡眠呼吸障碍的治疗，包括实施持续气道正压治疗，与 1-24 小时 ABPM 参数（尤其是夜间血压值）的降低相关。年随访。这些益处会随着时间的推移而减弱，只有患有严重 OSA 的受试者在 3 年内仍保持 ABPM 夜间时间减少。此外，未控制的血压、性别和年龄等临床变量对 1 年随访时的血压反应具有预测价值。

通过在高血压病房的一组 RH 患者中诊断和治疗 OSA，发现血压有良好的长期下降，但随着时间的推移，这种下降在严重 OSA 患者中仅部分维持。