Abstract
Background: OSA is highly prevalent among patients with resistant hypertension (RH). In RH patients with OSA, the blood pressure (BP) response to adherent use of CPAP is highly variable with patients showing major reductions while in other BP remains unchanged or worsens. MicroRNAs (miRNA) have been identified as playing significant roles in cardiovascular disease.
Aim: To identify initial miRNA candidate biomarkers among circulating miRNAs in the plasma of BP responders and non-responders in OSA patients with RH undergoing CPAP.
Methods: 41 male OSA patients with RH were identified and assessed before/after 3 months of adherent CPAP. 20 patients exhibited a reduction in mean BP (>4.5mmHg) (Responder Group (RG)) and in 21 patients, no significant reductions in mean BP occurred (Non-responder Group (NRG)). miRNAs were isolated and expression profiling of cardiovascular system-focused miRNA was performed. A logistic regression model was fitted to identify the miRNAs that predict the favorable BP response.
Results: Both RG and NRG groups had severe OSA. From the cardiovascular system functionally related miRNAs analyzed, 3 miRNAs provided a discriminatory predictive model of RG and NRG. The area under the curve was 0.91, with 95% CI (0.82,0.99). Analysis of the plasma levels of these 3 miRNAs enabled generation of a score (HIPARCO-Score) for estimates of the probability for favorable BP response to CPAP treatment.
Conclusions: A singular cluster of cardiovascular system functional miRNAs appears to specifically differentiate between OSA patients with RH whose BP favorably responds to CPAP treatment and those who do not.
- Copyright ©ERS 2015