Document Detail


Long-term effect of continuous positive airway pressure on BP in patients with hypertension and sleep apnea.
MedLine Citation:
PMID:  17925415     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To analyze the long-term effect of continuous positive airway pressure (CPAP) on ambulatory BP in patients with obstructive sleep apnea (OSA) and hypertension, and to identify subgroups of patients for whom CPAP could be more effective. METHODS: We conducted a prospective, long-term follow-up trial (24 months) in 55 patients with OSA and hypertension (mean CPAP use, 5.3 +/- 1.9 h/d [+/- SD]). Twenty-four-hour ambulatory BP monitoring (ABPM) was measured at baseline and after intervention with CPAP on an intention-to-treat basis. In addition, the correlation between the changes in 24-h mean arterial pressure (24hMAP) and CPAP compliance, OSA severity, and baseline ABPM was assessed. RESULTS: At the end of follow-up, a significant decrease was shown only in diastolic BP (- 2.2 mm Hg; 95% confidence interval [CI], - 4.2 to - 0.1; p = 0.03) but not in 24hMAP or other ABPM parameters. However, a correlation between changes in 24hMAP and baseline systolic BP (r = - 0.43, p = 0.001), diastolic BP (r = - 0.38, p = 0.004), and hours of use of CPAP (r = - 0.30, p = 0.02) was observed. A significant decrease in the 24hMAP was achieved in a subgroup of patients with incompletely controlled hypertension at entry (- 4.4 mm Hg; 95% CI, - 7.9 to - 0.9 mm Hg; p = 0.01), as well as in those with CPAP compliance > 5.3 h/d (- 5.3 mm Hg; 95% CI, - 9.5 to - 1.2 mm Hg; p = 0.01). Linear regression analysis showed that baseline systolic BP and hours of CPAP were independent predictors of reductions in BP with CPAP. CONCLUSION: Long-term CPAP reduced BP modestly in the whole sample. However, patients with higher BP at entry and good CPAP compliance achieved significant reductions in BP.
Authors:
Francisco Campos-Rodriguez; Jose Perez-Ronchel; Antonio Grilo-Reina; Jorge Lima-Alvarez; Maria A Benitez; Carmen Almeida-Gonzalez
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Publication Detail:
Type:  Journal Article     Date:  2007-10-09
Journal Detail:
Title:  Chest     Volume:  132     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-14     Completed Date:  2008-02-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1847-52     Citation Subset:  AIM; IM    
Affiliation:
Departments of Respiratory Medicine, Valme University Hospital 41020 Sevilla, Spain. fcamposr@telefonica.net
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure Monitoring, Ambulatory
Continuous Positive Airway Pressure*
Female
Follow-Up Studies
Humans
Hypertension / etiology*,  physiopathology,  therapy*
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Risk Factors
Sleep Apnea Syndromes / complications*,  physiopathology,  therapy*
Statistics, Nonparametric
Treatment Outcome

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


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