Abstract 15346: Blood Pressure Control Does Not Improve with Long-Term Continuous Positive Airway Pressure Above Conventional Antihypertensive Treatment: a 3-Year Follow-Up
Introduction: Even though obstructive sleep apnea (OSA) is strongly associated with hypertension, studies have generally shown only a mild blood pressure (BP)-lowering effect of continuous positive airway pressure (CPAP). Hypothesis: We hypothesized that long-term CPAP treatment should be associated with better BP control rates and a need for less antihypertensive drugs in patients with arterial hypertension.
Methods: We followed 91 non-sleepy patients (aged 54±9 years, 69 males) with essential hypertension and newly diagnosed moderate-to-severe OSA (apnea-hypopnea index, 38±24 events/hour on polysomnography) for a mean period of 3.1 years, after switching them to conventional antihypertensive treatment targeting office BP<140/90mmHg (<130/80mmHg in diabetics). Participants were defined as on-CPAP if they adhered to CPAP treatment during the whole follow-up period (N=41) while those that did not follow CPAP therapy served as controls (N=50).
Results: By the end of follow-up, on-CPAP subjects and controls exhibited similar systolic and diastolic BP levels (133±12 vs. 133±13mmHg, 84±9 vs. 85±9mmHg respectively, p>0.05 for all), number of patients with controlled hypertension (71% vs. 70%, p>0.05), and number of antihypertensive drugs needed to achieve BP control (2.28±1.09 vs. 2.11±0.72, p>0.05). In a subgroup of patients (N=34) in whom ambulatory BP monitoring was also performed, 24-hour BP levels did not differ between the two groups (125±10/76±7mmHg vs 123±11/75±10mmHg, p>0.05). In multiple regression models, CPAP application was not associated with changes in BP levels.
Conclusions: In non-sleepy, hypertensive, OSA patients on conventional antihypertensive treatment, long-term CPAP application is not associated with lower BP levels or a need for less antihypertensive drugs for BP control.
- © 2012 by American Heart Association, Inc.