title: Positive effect of CPAP treatment on the control of difficult-to-treat hypertension.
abstract: The aim of the present study was to analyse the role of continuous positive airway pressure (CPAP) treatment in patients with difficult-to-control hypertension (DC-HT) and sleep apnoea. An Autoset (ResMed, Sydney, Australia) study was performed in 60 patients diagnosed with DC-HT based on two 24-h ambulatory blood pressure monitorisation (ABPM) studies. CPAP was offered to patients with an apnoea/hypopnoea index (AHI) > or =15 events.h(-1). After 3 months of treatment, repeat ABPM was performed to evaluate the effect of CPAP upon the blood pressure values. A total of 39 (65%) patients received CPAP treatment, but only 33 completed the study. The mean+/-sd systolic and diastolic blood pressures (SBP and DBP, respectively) were 154.8+/-14 and 90+/-8.8 mmHg. Patients had a mean+/-sd AHI of 37.7+/-18.2 events.h(-1). Only three patients presented a dipper nocturnal pressure pattern. CPAP treatment significantly reduced SBP (-5.2 mmHg), and particularly the nocturnal values (-6.1 mmHg), but not DBP. Considering only those patients who tolerated CPAP, the decrease in SBP was greater (-7.3 mmHg). Furthermore, CPAP treatment significantly increased the percentage of patients who recovered the dipper pattern (three (9.1%) out of 33 versus 12 (36.4%) out of 33). Continuous positive airway pressure treatment significantly reduces systolic blood pressure, particularly at night, and normalises the nocturnal pressure pattern in patients with difficult-to-control hypertension and sleep apnoea.
authors.affiliation: Pneumology Unit, Requena General Hospital, Valencia, Spain. med013413@nacom.es
authors.forename: M A
authors.initials: MA
authors.lastname: Martínez-García
authors.forename: R
authors.initials: R
authors.lastname: Gómez-Aldaraví
authors.forename: J-J
authors.initials: JJ
authors.lastname: Soler-Cataluña
authors.forename: T G
authors.initials: TG
authors.lastname: Martínez
authors.forename: B
authors.initials: B
authors.lastname: Bernácer-Alpera
authors.forename: P
authors.initials: P
authors.lastname: Román-Sánchez
mesh_terms: D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D012891:Sleep Apnea Syndromes / Q000503:physiopathology / Q000628:therapy*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome