PS-R01-6: SUCCESSFUL ANTIHYPERTENSIVE TREATMENT USING SACUBITRIL/VALSARTAN ALONE IN A PATIENT WITH OBSTRUCTIVE SLEEP APNEA SYNDROME

Obstructive sleep apnea syndrome (O-SAS) is one of the emerging non-communicable health hazards with high rates of morbidity and mortality. O-SAS is known to induce excessive activity of sympathetic nervous system and result in secondary hypertension. Although continuous positive airway pressure (CPAP) is the first line therapy for O-SAS, its poor adherence induces resistant hypertension. Sacubitril/valsartan has a sympatho-inhibitory effect and may contribute to antihypertensive therapy in patients with O-SAS. We present a successful case of a 39-year-old male with O-SAS using sacubitril/valsartan alone. He visited our clinic with severe hypertension noted during a routine health checkup. He was a heavy drinker, resulted in high body mass index. His family members worried about his loud snoring and witnessed apnea during sleep. The polysomnography showed a markedly increased apnea-hypopnea index of 37, which led to a diagnosis of severe obstructive sleep apnea. At first, we started treatment with CPAP and azilsartan, but he stopped CPAP due to excessive drinking. Then, we switched azilsartan to sacubitril/valsartan, and succeeded in improving his blood pressure. This case indicates that sacubitril/valsartan may be an effective therapy for uncontrollable hypertenstion due to O-SAS even without CPAP.