| Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. | |
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MedLine Citation:
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PMID: 20577130 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of hypertension Volume: 28 ISSN: 1473-5598 ISO Abbreviation: J. Hypertens. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-16 Completed Date: 2011-01-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 2161-8 Citation Subset: IM |
Affiliation:
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Department of Pneumology, Hospital Mútua de Terrassa, Universitat Autònoma de Barcelona, Barcelona, Spain. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Antihypertensive Agents |
| Comments/Corrections | |
Comment In:
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J Hypertens. 2010 Oct;28(10):2012-5
[PMID:
20844370
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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