Positive effect of cpap treatment on the control of difficult-to-treat hypertension

¹ Pneumology Unit
² Cardiology Unit
³ Service of Internal Medicine, Requena General Hospital, Valencia (Spain)

^* To whom correspondence should be addressed. E-mail: med013413{at}nacom.es.

	Abstract

To analyze the role of CPAP treatment in patients with difficult-to-control hypertension (DC-BP) and sleep apnoea.

An Autoset study was made in 60 patients diagnosed with DC-BP based on two 24-hour ambulatory blood pressure monitorization (ABPM) studies. CPAP was offered to those patients with an apnoea-hypopnoea index (AHI) of 15. After three months of treatment, repeat ABPM was performed to evaluate the effect of CPAP upon the blood pressure values.

Thirty-nine patients (65%) received CPAP treatment, but only 33 completed the study. The mean (SD) systolic blood pressure (SBP)/ diastolic blood pressure (DBP) was 154.8 (14)/ 90 (8.8) mmHg. The patients had a mean AHI (SD) of 37.7 (18.2). Only 3 patients presented a dipper nocturnal pressure pattern. CPAP treatment significantly reduced SBP (-5.2 mmHg; p: 0.01), particularly the nocturnal values (-6.1 mmHg; p=0.01), but not DBP. Considering only those patients who tolerated CPAP, the decrease in SBP was greater (-7.3 mmHg; p:0.009). CPAP treatment moreover significantly increased the percentage of patients who recovered the dipper pattern (9.1% vs 12 36.4%; p: 0.004).

CPAP treatment significantly reduces SBP, particularly at night, and normalizes the nocturnal pressure pattern in patients with DC-BP and sleep apnoea.

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