title: Effects of CPAP on systemic hypertension in OSAH: a monocentric, observational, cohort study.
abstract: BACKGROUND
  Obstructive sleep apnea-hypopnea (OSAH) is a risk factor for development of systemic arterial hypertension (SAH) and can worse the control of established SAH. We investigated the effects of long-term continuous positive airway pressure (CPAP) treatment in controlling and preventing SAH in a large cohort of subjects referred for sleep study for suspected OSAH.
  
  
  METHODS
  In 495 subjects of whom 422 with OSAH and 73 without OSAH, the clinical history was obtained, arterial blood pressure was measured and the current anti-hypertensive drugs was recorded at diagnosis and/or at CPAP start. Subjects were interviewed after a follow-up period of (mean ± SD) 3.4 ± 2.2 yr (range 1-8 yr) and divided in patients with moderate-to-severe OSAH (n = 125) who referred to use CPAP regularly for at least 4 h every night (group 1), with moderate-to-severe OSAH (n = 70) who refused or abandoned the CPAP treatment after few weeks (group 2), with mild OSAH (n = 227) with no CPAP indication (group 3) and simple snorers or normals (n = 73) (group 4). For each group clinical status, BMI, and changes in SAH therapy and occurrence of SAH were assessed at the follow-up.
  
  
  RESULTS
  At the follow-up, a higher risk of increasing treatment for SAH was found for group 2 and group 3 versus group 1 (OR = 5, 95%CI 1-20, p < 0.01 and OR = 3, 95%CI 1-10, p < 0.05), respectively. The occurrence of SAH was lower (p < 0.001) in the group 1 (1.9%), vs group 2 (35.9%), 3 (21.1%) and 4 (18.6%).
  
  
  CONCLUSIONS
  In moderate-to-severe OSAH patients, long-term CPAP treatment significantly reduces the development of SAH and, in those with SAH at baseline, the need of anti-hypertensive drugs.
authors: Divisione di Medicina Interna, Laboratorio per le patologie sonno-correlate, Ospedale di Umbertide, Perugia, Italy.
authors: Paolo
authors: P
authors: Bottini
authors: Luigi
authors: L
authors: Taranto-Montemurro
authors: Mauro
authors: M
authors: Novali
authors: Michela
authors: M
authors: Bettinzoli
authors: Elisa
authors: E
authors: Roca
authors: Chiara
authors: C
authors: Andreoli
authors: Maurizio
authors: M
authors: Bentivoglio
authors: Luciano
authors: L
authors: Corda
authors: Claudio
authors: C
authors: Tantucci
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome