Effect of continuous positive airway pressure therapy on 24-hour blood pressure in patients with obstructive sleep apnea syndrome

• Published in: American journal of hypertension Vol. 15; no. 3; pp. 251 - 257
• Main Authors: Sanner, Bernd M, Tepel, Martin, Markmann, Alexander, Zidek, Walter
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2002; Oxford University Press; Elsevier Science
• Subjects: arterial pressure; Biological and medical sciences; Blood Pressure - physiology; Continuous positive airway pressure; Diseases of the respiratory system; Female; Follow-Up Studies; Heart Rate; Humans; Hypertension - etiology; Male; Medical sciences; Middle Aged; obstructive sleep apnea syndrome; Polysomnography; Positive-Pressure Respiration; pulse pressure; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Sleep; Sleep Apnea, Obstructive - physiopathology; Sleep Apnea, Obstructive - therapy; systemic hypertension; pulse pressure; obstructive sleep apnea syndrome; arterial pressure; Sleep; systemic hypertension; Human; Hypertension; Sleep apnea syndrome; Respiratory disease; Treatment efficiency; Instrumentation therapy; Sleep disorder; Cardiovascular disease; Exploration; Concomitant disease; Treatment; Positive pressure; Blood pressure; Predictive factor
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/S0895-7061(01)02292-0

Patients with obstructive sleep apnea syndrome (OSAS) are subject to an increased cardiovascular morbidity including systemic hypertension. Little is known about the effects of treatment with nasal continuous positive airway pressure (CPAP) on systemic hypertension. Automated ambulatory 24-h blood pressure (BP) monitoring was performed in 88 consecutive patients who were referred for evaluation of snoring or suspected OSAS. In addition, the long-term effects of CPAP therapy on 24-h BP were assessed. A total of 62 patients had OSAS and 26 habitual snoring. Patients with OSAS had significantly higher mean arterial BP values than snorers (102.7 ± 10.7 v 94.0 ± 10.2 mm Hg; P < .01). Multiple stepwise linear regression analysis disclosed that the degree of systemic hypertension was independently associated with the severity of OSAS as determined by the apnea/hypopnea index (R = 0.43; P < .001), but not with age, body mass index, or smoking habits. Of the 62 patients with OSAS, 52 were treated with CPAP and reevaluated after 9 months. The CPAP resulted in a significant decrease in mean arterial BP (from 103.7 ± 10.4 to 99.1 ± 10.8 mm Hg; P < .05). For those patients with systemic hypertension whose BP improved with CPAP therapy, 24-h mean pulse pressure at baseline (r = −0.36; P < .05) as well as average heart rate during the day (r = −0.35; P < .05) turned out as predictors. Obstructive sleep apnea syndrome contributes, at least in part, to the development of systemic hypertension, and CPAP may improve BP values in treated OSAS patients. Predictors of a beneficial CPAP effect on BP are a high heart rate and a high pulse pressure before treatment.