In patients with persistent hypertension and obstructive sleep apnea, 3-month continuous positive airway pressure (CPAP) therapy significantly reduces systolic and diastolic pressure and normalizes nocturnal BP patterns.

This is evidenced by the data of a report published recently by Spanish scientists in JAMA..

\; mean pressure decreases by 1.3 mm, systolic pressure by 1.9 mm, and diastolic pressure by 1.0 mm for each additional hour of CPAP therapy,"

" Our study suggests a significant benefit from CPAP therapy for this subset of patients."

" rt. st. ) may have a clinically significant effect in reducing cardiovascular mortality: a 6-8% reduction in the risk of stroke and a 4-5% reduction in the risk of heart attack,"

Previous studies have shown that CPAP leads to clinically significant reductions in blood pressure, but all of these studies " Therefore, Dr. Martinez-Garcia and his colleagues initiated a large, randomized, multicenter study to investigate this issue..

They selected 194 adult participants who were treated in 24 teaching hospitals across Spain.. All of them suffered from sustained hypertension unrelated to causes such as primary aldosteronism, renal artery stenosis, or chronic renal failure.. Persistent hypertension was confirmed by 24-hour blood pressure monitoring.

Study subjects also had obstructive sleep apnea, which was confirmed by standard diagnostics in sleep laboratories..

The study participants were randomized into groups, one of which received CPAP therapy (98 patients), and the second was used for control (96 patients), that is, continued to take previously prescribed antihypertensive drugs without additional treatment.. Approximately 69% of participants were male, mean age was 56, mean body mass index was 34.1, mean number of antihypertensive medications was 3.8, and mean apnea-hypopnea index was 40.4 per hour..

After 3 months, the CPAP group achieved a significant reduction in 24-hour mean blood pressure, with improvements more pronounced at night.. At the same time, this group managed to achieve normalization of nocturnal BP patterns, which helps to reduce cardiovascular risk..

In a protocol analysis that included 71 patients on CPAP and 87 controls who followed the protocol fully, these improvements were even more significant.. In the CPAP group, mean 24-hour blood pressure decreased by 4.4 mm, systolic blood pressure by 4.9 mm, and diastolic blood pressure by 4.1 mm. rt. st.

At night, these figures were even better: the decrease in systolic pressure was 7.1 mm. And, again, the CPAP group was more likely to achieve normalization of nocturnal blood pressure patterns..

A linear relationship was also found between the number of hours of CPAP therapy per night and the decrease in mean daily blood pressure, i.e. the treatment effect was dose-dependent..

"

Further studies, according to the doctor, should evaluate how these results affect the long-term prognosis in patients from this subgroup..

The study was supported by Philips Respironics, Spanish Society of Pneumology, Instituto SCIII, Society of Pneumology of Valencia. Scholars reported no conflicts of interest.

medbe. en.