当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > Precision Medicine in Patients With Resistant Hypertension and Obstructive Sleep Apnea: Blood Pressure Response to Continuous Positive Airway Pressure Treatment.

Precision Medicine in Patients With Resistant Hypertension and Obstructive Sleep Apnea: Blood Pressure Response to Continuous Positive Airway Pressure Treatment.

Abstract：

BACKGROUND:In patients with resistant hypertension (RH) and obstructive sleep apnea (OSA), the blood pressure response to continuous positive airway pressure (CPAP) treatment is highly variable and could be associated with differential micro-ribonucleic acid (miRNA) profiles. Currently, no available methods exist to identify patients who will respond favorably to CPAP treatment. OBJECTIVES:The aim of this study was to identify plasma miRNA profiles that predict blood pressure responses to CPAP treatment. METHODS:Cardiovascular system-focused circulating miRNA expression was evaluated in plasma samples using an 84-miRNA array among patients with RH and OSA at baseline and after 3 months of adherent CPAP use. Pathway analysis and miRNA target gene enrichment were performed in silico. Plasma levels of peptides and hormones related to cardiovascular function were also measured. RESULTS:The OSA responder group exhibited blood pressure decreases exceeding the observed median (>4.5 mm Hg) after CPAP, which were not present in the nonresponder group (≤4.5 mm Hg) (p < 0.01). Three miRNAs provided a discriminatory predictive model for such a favorable blood pressure response to CPAP (area under the curve: 0.92; p = 0.01). Additionally, CPAP treatment significantly altered a total of 47 plasma miRNAs and decreased aldosterone-to-renin ratios in the responder group (p = 0.016) but not in the nonresponder group. CONCLUSIONS:A singular pre-CPAP treatment cluster of 3 plasma miRNAs predicts blood pressure responses to CPAP treatment in patients with RH and OSA. CPAP treatment is accompanied by changes in cardiovascular system-related miRNAs that may potentially influence the risk for cardiovascular disease among patients with OSA and RH. (Effect of Continuous Positive Airway Pressure [CPAP] Treatment in the Control of Refractory Hypertension; NCT00616265).

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Sánchez-de-la-Torre M,Khalyfa A,Sánchez-de-la-Torre A,Martinez-Alonso M,Martinez-García MÁ,Barceló A,Lloberes P,Campos-Rodriguez F,Capote F,Diaz-de-Atauri MJ,Somoza M,González M,Masa JF,Gozal D,Barbé F,Spanish Sleep Network

doi

10.1016/j.jacc.2015.06.1315

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

1023-32

issue

9

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(15)04270-9

journal_volume

66

pub_type

杂志文章,多中心研究,随机对照试验

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