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Obstructive Sleep Apnoea — EECC MCQ

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ModerateGeneral CardiologyObstructive Sleep ApnoeaEECC

A 58-year-old obese man with resistant hypertension and atrial fibrillation undergoes a sleep study which reveals severe obstructive sleep apnoea (OSA) with an apnoea-hypopnoea index (AHI) of 42/hour. Which cardiovascular effect of OSA treatment with CPAP has the strongest evidence?

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Correct answer: C — Reduction in blood pressure and improvement in AF management

OSA is an independent risk factor for hypertension (particularly resistant hypertension), AF, and heart failure. CPAP therapy has demonstrated consistent evidence for blood pressure reduction (approximately 2-3 mmHg), which is particularly relevant in resistant hypertension. OSA treatment is also associated with improved AF management: the ARREST-AF study showed that aggressive OSA treatment significantly reduced AF recurrence after ablation. However, the SAVE trial (the largest RCT of CPAP in CVD) did not demonstrate a reduction in major cardiovascular events (MI, stroke, CV death). The 2024 ESC Hypertension Guidelines recommend screening for and treating OSA as part of resistant hypertension evaluation.

Reference: ESC (2024): Guidelines for Hypertension; ESC (2024): AF Guidelines