Document Detail


Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial.
MedLine Citation:
PMID:  20577130     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This controlled trial assessed the effect of continuous positive airway pressure (CPAP) on blood pressure (BP) in patients with obstructive sleep apnea (OSA) and resistant hypertension (RH).
METHODS: We evaluated 96 patients with resistant hypertension, defined as clinic BP at least 140/90 mmHg despite treatment with at least three drugs at adequate doses, including a diuretic. Patients underwent a polysomnography and a 24-h ambulatory BP monitoring (ABPM). They were classified as consulting room or ABPM-confirmed resistant hypertension, according to 24-h BP lower or higher than 125/80 mmHg. Patients with an apnea-hypopnea index at least 15 events/h (n = 75) were randomized to receive either CPAP added to conventional treatment (n = 38) or conventional medical treatment alone (n = 37). ABPM was repeated at 3 months. The main outcome was the change in systolic and diastolic BP.
RESULTS: Sixty-four patients completed the follow-up. Patients with ABPM-confirmed resistant hypertension treated with CPAP (n = 20), unlike those treated with conventional treatment (n = 21), showed a decrease in 24-h diastolic BP (-4.9 ± 6.4 vs. 0.1 ± 7.3 mmHg, P = 0.027). Patients who used CPAP > 5.8 h showed a greater reduction in daytime diastolic BP {-6.12 mmHg [confidence interval (CI) -1.45; -10.82], P = 0.004}, 24-h diastolic BP (-6.98 mmHg [CI -1.86; -12.1], P = 0.009) and 24-h systolic BP (-9.71 mmHg [CI -0.20; -19.22], P = 0.046). The number of patients with a dipping pattern significantly increased in the CPAP group (51.7% vs. 24.1%, P = 0.008).
CONCLUSION: In patients with resistant hypertension and OSA, CPAP treatment for 3 months achieves reductions in 24-h BP. This effect is seen in patients with ABPM-confirmed resistant hypertension who use CPAP more than 5.8 h.
Authors:
Lourdes Lozano; José Luis Tovar; Gabriel Sampol; Odile Romero; María José Jurado; Alfons Segarra; Eugènia Espinel; José Ríos; María Dolores Untoria; Patrícia Lloberes
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  2161-8     Citation Subset:  IM    
Affiliation:
Department of Pneumology, Hospital Mútua de Terrassa, Universitat Autònoma de Barcelona, Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Antihypertensive Agents / pharmacology,  therapeutic use
Blood Pressure / drug effects,  physiology
Blood Pressure Monitoring, Ambulatory
Combined Modality Therapy
Comorbidity
Continuous Positive Airway Pressure*
Female
Follow-Up Studies
Humans
Hypertension / epidemiology,  physiopathology,  therapy*
Male
Middle Aged
Prospective Studies
Severity of Illness Index
Sleep Apnea, Obstructive / epidemiology,  physiopathology,  therapy*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections
Comment In:
J Hypertens. 2010 Oct;28(10):2012-5   [PMID:  20844370 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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