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Cited by 102Obstructive Sleep Apnea ResearchBlood Pressure and Hypertension StudiesSleep and related disorders

Effects of Nocturnal Continuous Positive Airway Pressure Therapy in Patients with Resistant Hypertension and Obstructive Sleep Apnea

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Dernaika, Tarek A., Kinasewitz, Gary T., Tawk, Maroun M.·2009·Journal of Clinical Sleep Medicine
DOI 10.5664/jcsm.27435PMC PMC2670326
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Abstract

Study objective To examine the long-term effects of continuous positive airway pressure (CPAP) therapy on blood pressure (BP) in patients with obstructive sleep apnea and resistant hypertension.Methods Study subjects were 98 patients with obstructive sleep apnea syndrome and hypertension who had 3 or more documented daytime BP measurements taken within 3 months of enrollment and every 3 months after CPAP initiation for 1 year. Resistant hypertension was defined as daytime BP of at least 140 mm Hg systolic or 90 mm Hg diastolic, despite the use of 3 or more antihypertensive medications. Patients in the resistant hypertension group (n = 42) were compared with subjects with controlled hypertension (n = 56).Results Mean difference in mean arterial pressure was -5.6 (95% confidence interval [CI] -2.0 to -8.7 mm Hg; p = 0.03) in the resistant group and -0.8 mm Hg (95% CI -2.9 to 3.3 mm Hg; p = 0.53) in patients with controlled BP at the end of follow up period. CPAP permitted de-escalation of antihypertensive treatment in 71% of subjects with resistant hypertension but did not significantly alter the antihypertensive regimen in the controlled group. Multivariate regression analysis showed that baseline BP (odds ratio 5.4, 95% CI 2.3 to 8.9; p = 0.01) and diuretic therapy (odds ratio = 3.2, 95% CI 1.8 to 6.1; p = 0.02), but not apnea-hypopnea index or hours of CPAP use, were independently associated with a decrease in mean arterial pressure after 12 months of CPAP therapy.Conclusion In this observational study, CPAP was associated with different effects on blood pressure control in hypertensive patients with sleep apnea. A beneficial response to CPAP therapy was found mainly in subjects with the most severe hypertensive disease.

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  1. [3]3. between sleep-disordered breathing and hypertension. N Engl J Med 2000;342:1378-84. - Hla KM, Young TB, Bidwell T. Sleep apnea and hypertension. A
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Authors
Dernaika, T. A., Kinasewitz, G. T., & Tawk, M. M.
Affiliations
  • University of Oklahoma Medical Center (US)
  • University of Oklahoma Health Sciences Center (US)
Corresponding author
Dernaika, Tarek A.
Venue
Journal of Clinical Sleep Medicine
Publisher
Springer Science and Business Media LLC
Published
2009-04-15
Volume
5
Issue
2
Pages
103-107
ISSN
  • 1550-9389 (ISSN-L)
  • 1550-9397
DOI
10.5664/jcsm.27435
PMC
PMC2670326
OpenAlex
W219218098
Cited by
102
References
34
Citations by year
2026: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2020: 5 · 2019: 2 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 12 · 2014: 17 · 2013: 11 · 2012: 16
FWCI
8.61
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Sleep Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
continuous positive airway pressure, obstructive sleep apnea, resistant hypertension, blood pressure control, diuretic therapy, mean arterial pressure, apnea-hypopnea index
MeSH terms
Antihypertensive Agents, Drug Resistance, Female, Humans, Hypertension, Male, Middle Aged, Retrospective Studies, Comorbidity, Multivariate Analysis, Logistic Models, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure

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