CPAP Treatment Supported by Telemedicine Does Not Improve Blood Pressure in High Cardiovascular Risk OSA Patients: A Randomized, Controlled Trial
Open accessAbstract
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) has been associated with hypertension, which is one of the intermediary mechanisms leading to increased cardiovascular morbidity. This study aimed at evaluating the effects of a combination of continuous positive airway pressure (CPAP) and telemedicine support on blood pressure (BP) reduction in high cardiovascular risk OSA patients. DESIGN: A multi-center randomized controlled trial that compared standard CPAP care and CPAP care and a telemedicine intervention. SETTING: Sleep clinics in France. PATIENTS OR PARTICIPANTS: 107 adult (18-65 years old) OSA patients (AHI > 15 events/h) with a high cardiovascular risk (cardiovascular SCORE > 5% or secondary prevention). INTERVENTIONS: Patients were randomized to either standard care CPAP (n = 53) or CPAP and telemedicine (n = 54). Patients assigned to telemedicine were equipped with a smartphone for uploading BP measurements, CPAP adherence, sleepiness, and quality of life data; in return, they received pictograms containing health-related messages. MEASUREMENTS: The main outcome was home self-measured BP and secondary outcomes were cardiovascular risk evolution, objective physical activity, CPAP adherence, sleepiness and quality of life. RESULTS: Self-measured BP did not improve in either group (telemedicine or standard care). Patients in primary prevention showed greater BP reduction with CPAP treatment than those in secondary prevention. CONCLUSIONS: CPAP treatment supported by telemedicine alone did not improve blood pressure and cardiovascular risk in high cardiovascular risk OSA patients. This study emphasizes the need for diet and physical activity training programs in addition to CPAP when aiming at decreasing cardiometabolic risk factors in these patients. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov identifier: NCT01226641.
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CPAP's effect on cardiovascular biomarkers such as C-reactive protein and lipids is more variable than its effect on blood pressure.
“Although most (but not all) studies and the above meta-analysis support a modest effect of CPAP on blood pressure, the effect on biomarkers associated with cardiovascular risk such as C-reactive protein has been more variable.”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [169]
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- Authors
- Mendelson, M., Vivodtzev, I., Tamisier, R., Laplaud, D., Dias-Domingos, S., Baguet, J.-P., Moreau, L., Koltes, C., Chavez, L., De Lamberterie, G., Herengt, F., Levy, P., Flore, P., & Pépin, J.-L.
- Affiliations
- Inserm (FR)
- IP Santé Domicile, Lyon, France
- Centre Hospitalier Universitaire de Grenoble (FR)
- Polyclinique de Gentilly, Nancy, France
- Service de Pneumologie, Saint Avold, France
- Cabinet Marcel Benoit, Grenoble, France
- Dieulefit Santé, Domaine Chamonix, Dieulefit, France
- ORCID
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-11-01
- Volume
- 37
- Issue
- 11
- Pages
- 1863-1870
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC4196069
- OpenAlex
- W2326201314
- Cited by
- 72
- References
- 41
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 10 · 2021: 6 · 2020: 10 · 2019: 5 · 2018: 10 · 2017: 13 · 2016: 7 · 2014: 1
- FWCI
- 4.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- obstructive sleep apnea, continuous positive airway pressure, telemedicine, blood pressure, hypertension, cardiovascular risk, self-measured blood pressure, CPAP adherence, sleepiness, quality of life, physical activity, cardiometabolic risk, smartphone-based monitoring
- MeSH terms
- Blood Pressure, Diet, Exercise Therapy, Female, France, Humans, Hypertension, Male, Middle Aged, Quality of Life, Risk, Sleep Stages, Telemedicine, Sleep Apnea, Obstructive, Cell Phone, Continuous Positive Airway Pressure
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