SUPPLEMENTIAL DATA

CLINICAL CHARACTERISTICS OF PATIENTS WITH RESISTANT HYPERTENSION: THE RESIST - POL STUDY

Supplementary Figure 1. Study flow chart.

Supplementary Table 1. Clinical characteristics according to the severity of obstructive sleep apnea.

Characteristics / No OSA / Mild OSA / Moderate OSA / Severe OSA / p / p1 / p2 / p3
N / 57 / 55 / 38 / 54
Males, % / 42.1 / 45.5 / 73.7 / 85.2 / <0.001 / 0.72 / 0.041 / <0.001
Age, years / 44.7 ± 11.7 / 47.7 ± 10.6 / 49.9 ± 8.8 / 52.1 ± 9.4 / 0.022 / 0.31 / 0.046 / 0.001
Known history of hypertension, years / 8.9 ± 7.6 / 10.9 ± 8.8 / 12.1 ± 9.5 / 12.3 ± 8.1 / 0.17 / 0.48 / 0.20 / 0.11
Body mass index, kg/m2 / 27.7 ± 4.5 / 29.6 ± 4.3 / 31.4 ± 3.8 / 32.2 ± 4.6 / <0.001 / 0.054 / <0.001 / <0.001
Abdominal obesity, % / 52.6 / 70.9 / 86.8 / 87.0 / <0.001 / 0.050 / 0.001 / <0.001
Smoking, % / 21.6 / 11.1 / 16.7 / 22.6 / 0.39 / 0.15 / 0.57 / 0.90
Increased fasting glucose, % / 45.6 / 43.6 / 50.0 / 53.7 / 0.003 / 0.86 / 0.50 / 0.036
Impaired glucose tolerance, % / 14.0 / 18.2 / 28.9 / 25.9 / <0.001 / 0.97 / 0.007 / 0.008
Newly recognized diabetes, % / 7.0 / 5.5 / 10.5 / 33.3 / <0.001 / 0.96 / 0.55 / 0.001
Metabolic syndrome, % / 50.9 / 61.8 / 71.1 / 81.5 / 0.007 / 0.24 / 0.050 / 0.001
Sodium / 141.6 ± 2.9 / 141.4 ± 2.5 / 142.5 ± 1.7 / 142.9 ± 2.7 / 0.016 / 0.98 / 0.2 / 0.019
Potassium / 4.2 ± 0.5 / 4.3 ± 0.4 / 4.3 ± 0.5 / 4.3 ± 0.4 / 0.82 / 0.72 / 0.80 / 0.93
Fasting glucose, mg/dL / 101.8 ± 11.3 / 102.1 ± 11.7 / 101.5 ± 12.1 / 113.7 ± 22.1 / <0.001 / 1.00 / 1.00 / <0.001
Glucose 2h OGTT, mg/dL / 119.6 ± 38.0 / 120.0 ± 39.3 / 132.0 ± 44.7 / 161.4 ± 63.2 / <0.001 / 1.00 / 0.50 / <0.001
Creatinine, mg/dL / 0.89 ± 0.2 / 0.84 ± 0.21 / 0.94 ± 0.22 / 0.93 ± 0.22 / 0.09 / 0.41 / 0.62 / 0.76
GFR, mL/min/1.73m2 / 87.4 ± 20.1 / 93.7 ± 20.0 / 89.1 ± 21.9 / 92.3 ± 21.2 / 0.37 / 0.26 / 0.96 / 0.46
Uric acid. mg/dL / 5.5 ± 1.5 / 5.6 ± 1.2 / 6.2 ± 1.6 / 6.6 ± 1.4 / <0.001 / 0.99 / 0.063 / <0.001
Total cholesterol, mg/dL / 195.5 ± 43.8 / 204.1 ± 40.9 / 186.9 ± 40.0 / 189.4 ± 47.1 / 0.21 / 0.51 / 0.75 / 0.87
LDL cholesterol, mg/dL / 122.2 ± 35.9 / 129.2 ± 37.3 / 119.0 ± 34.9 / 124.7 ± 44.3 / 0.62 / 0.66 / 0.96 / 0.98
HDL cholesterol, mg/dL / 53.6 ± 16.8 / 54.7 ± 15.9 / 47,9 ± 11,1 / 47,5 ± 19,9 / 0,055 / 0,67 / 0,26 / 0,15
Triglicerides, mg/dL / 141,5 ± 95,7 / 141,0 ± 101,0 / 147,4 ± 73,0 / 176,3 ± 104,4 / 0,18 / 1,00 / 0,99 / 0,15
24-h urinary sodium > 200 mEq/24h, % / 28.1 / 30.9 / 36.8 / 38.9 / 0.61 / 0.74 / 0.37 / 0.23
Aldosterone 24-h urine excretion, µg/24h 4 / 19.3±10.9 / 17.0±7.5 / 18.5±5.9 / 21.7±9.9 / 0.13 / 0.65 / 1.00 / 0.98
Aldosterone-to-renin ratio, pg/mL:ng/mL/h 4 / 21.1±26.2 / 27.8±30.0 / 20.7±27.5 / 23.5±37.3 / 0.74 / 0.52 / 0.98 / 0.50
No. of antihypertensive medications, n / 5 (4-6) / 4 (3-6) / 4 (3.75-5) / 5 (4-6) / 0.46 / 0.83 / 0.57 / 0.96
LVH. % / 49.1 / 44.4 / 57.9 / 66.0 / 0.12 / 0.63 / 0.40 / 0.083
Microalbuminuria. % / 23.5 / 20.8 / 25.7 / 31.4 / 0.66 / 0.75 / 0.82 / 0.38

p¹Statistical significance ofdifferencesin patients withoutOSAvspatientswith mildOSA

p²Statistical significance ofdifferencesin patients withoutOSAvspatientswith moderateOSA

p³Statistical significance ofdifferencesin patients withoutOSAvspatientswith severeOSA

4 – after exclusion of patients with secondary hypertension

Continuous variables are presented by mean±SD, discrete variables are presented as median and interquartile range.

OGTT – oral glucose tolerance test, GFR - glomerular filtration rate, LVH – left ventricular hypertrophy, OSA – obstructive sleep apnea

Supplementary Table 2. Clinic BP, 24h ambulatory blood pressure monitoring according to the severity of obstructive sleep apnea

Characteristics / No OSA / Mild OSA / Moderate OSA / Severe OSA / p / p1 / p2 / p3
N / 57 / 55 / 38 / 54
Clinic systolic BP, mmHg / 160 ± 23 / 158 ± 22 / 161± 23 / 163± 18 / 0,71 / 0,99 / 0,99 / 0,73
Clinic diastolic BP, mmHg / 96 ± 15 / 94 ± 14 / 98 ± 13 / 98 ± 14 / 0,45 / 0,95 / 0,79 / 0,62
Daytime systolic BP, mmHg / 146 ± 22 / 144 ± 18 / 143 ± 19 / 146 ± 18 / 0,80 / 0,86 / 0,76 / 1,00
Daytime diastolic BP, mmHg / 90 ± 15 / 89 ± 11 / 91 ± 14 / 91 ± 11 / 0,88 / 0,91 / 1,00 / 1,00
Daytime heart rate, bpm / 73 ± 12 / 71 ± 11 / 70 ± 11 / 72 ± 10 / 0,70 / 0,84 / 0,51 / 0,93
Nocturnal systolic BP, mmHg / 132 ± 21 / 129 ± 17 / 129 ± 15 / 136 ± 19 / 0,21 / 0,76 / 0,67 / 0,62
Nocturnal diastolic BP, mmHg / 79 ± 14 / 78 ± 12 / 78 ± 12 / 81 ± 10 / 0,39 / 0,97 / 0,96 / 0,52
Nighttime heart rate, bpm / 66 ± 11 / 66 ± 10 / 63 ± 11 / 66 ± 12 / 0,62 / 1,00 / 0,63 / 1,00
Nighttime systolic BP nondipping, % / 45,5 / 43,6 / 64,9 / 32,7 / 0,14 / 0,50 / 0,053 / 0,12
Nighttime diastolic BP nondipping, % / 61,8 / 63 / 67,6 / 50 / 0,17 / 0,53 / 0,37 / 0,15

p¹Statistical significance ofdifferencesin patients withoutOSAvspatientswith mildOSA

p²Statistical significance ofdifferencesin patients withoutOSAvspatientswith moderateOSA

p³Statistical significance ofdifferencesin patients withoutOSAvspatientswith severeOSA

Continuous variables are presented by mean±SD

OSA – obstructive sleep apnea,

BP – blood pressure,

Supplementary Table 3. Predictors of severe obstructive sleep apnea in patients with true resistant hypertension.

Univariate / Multivariate
Variable / OR / p / OR / 95% CI / p
Male sex / 5,45 / <0,001 / 9,35 / 3,35-26,12 / <0,001
Age1 / 1,67 / 0,004
Abdominal obesity / 3,16 / 0,009 / 2,74 / 1,02-7,35 / 0,045
Obesity (BMI≥30kg/m2) / 2,35 / <0,001
FPG ≥ 5,6 mmol/L / 2,57 / 0,005
2hPG ≥ 7,7 mmol/L / 3,20 / 0,001 / 6,54 / 2,34-18,25 / <0,001
Newly diagnosed diabetes / 5,28 / <0,001
Metabolic syndrome / 2,93 / 0,006
Systolic BP nondipping / 2,03 / 0,036
Daytime systolic BP2 / 1,05 / 0,56
Nighttime systolic BP2 / 1,17 / 0,065
Nighttime systolic BP decrease3 / 0,58 / 0,23
Increased neck circumference / 2,27 / 0,019
Snoring / 3,55 / 0,003
Epworth Sleepiness Score / 1,08 / 0,044

1 – 10-years increase; 2- 10 mm Hg increase; 3 – 10% decrease; BP – blood pressure; FPG – fasting plasma glucose; 2hPG – plasma glucose level 2 hours after glucose administration;The correlates of severe OSA were estimated in relation to all other patients (including moderate and mild OSA as well as patients without OSA).