Résumé
Background: Whether PAP therapy adherence is associated with a reduction in oral antihypertensive drugs (OADs) burden remains unclear.Aims and objectives: This study aimed to assess the association between the adherence to PAP therapy and the delivery of OADs.Methods: Data from the IRSR Pays de la Loire Sleep Cohort were linked with the French health insurance database to identify OAD delivery in patients with prevalent hypertension at OSA diagnosis. OAD classification followed the 2023 international guidelines. The primary endpoint was the difference in the number of OAD classes at one year compared to baseline (mean delta OAD) in PAP-adherent patients (AP), defined as those with a median PAP use of ≥ 4 hours per day (h/d), versus PAP non-adherent patients (NAP), with PAP use < 4 h/d or PAP termination.Results: The analysis included 2205 patients (68.0% male) with a median age of 61 years (IQ1-Q3: 54-68), BMI of 32.4 kg/m2 (28.9-36.4), and initial AHI of 39/h (30-55). At OSA diagnosis, 33.6% were treated with 1 OAD, 32.8% with 2 OADs, 33.5% with 3 or more OADs. At one year follow up, 78.1% were AP (median PAP use 6.52 (5.52-7.76) h/d and 21.9% were NAP (PAP use 2.58 (1.41-3.34) h/d or PAP termination). Mean (SD) delta OAD was -0.02 (±0.58) and -0.04 (±0.7) in AP and NAP respectively (p=0.68). The number of OADs decreased by 11.1% and 13.5%, and increased by 10.5% and 12.1% in AP and NAP (p=0.11).Conclusions: In real-life settings, we found no association between adherence to PAP therapy of OSA and the number of OAD classes delivered at one year. Further subgroup analyses are ongoing.