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Effects of Nocturnal Continuous Positive Airway Pressure Therapy in Patients with Resistant Hypertension and Obstructive Sleep Apnea
Open accessAbstract
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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“Poor BP control is strongly associated with OSA, especially in those patients with an apnea/hypopnea index of at least 30 events per hour.261”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [261]
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Metadata
- 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
- Published
- 2009-04-15
- Volume
- 5
- Issue
- 2
- Pages
- 103-107
- ISSN
- 1550-9389 (ISSN-L)
- 1550-9397
- 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
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Sleep Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › 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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