Context-Systemic hypertension is prevalent among patients with obstructive sleep apnea (OSA). Short-term studies indicate that continuous positive airway pressure (CPAP) therapy reduces blood pressure in patients with hypertension and OSA.Objective-To determine whether CPAP therapy is associated with a lower risk of incident hypertension.Design, Setting, and Participants-A prospective cohort study of 1889 participants without hypertension who were referred to a sleep center in Zaragoza, Spain, for nocturnal polysomnography between January 1, 1994, and December 31, 2000. Incident hypertension was documented at annual follow-up visits up to January 1, 2011. Multivariable models adjusted for Corresponding Author: José M. Marin, MD, Respiratory Department, Hospital Universitario Miguel Servet, Avda Isabel la Católica, 1-3, 50006 Zaragoza, Spain (jmmarint@unizar.es).. Author Contribution: Dr Marin had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Conclusion-Compared with participants without OSA, the presence of OSA was associated with increased adjusted risk of incident hypertension; however, treatment with CPAP therapy was associated with a lower risk of hypertension.
HHS Public AccessOBSTRUCTIVE SLEEP APNEA (OSA), a prevalent condition that is estimated to affect 17% of US adults, is associated with an increased risk for cardiovascular diseases and overall mortality. [1][2][3][4][5] Although treatment of OSA with continuous positive airway pressure (CPAP) therapy is associated with decreased overall cardiovascular risk, its efficacy in preventing new-onset hypertension is unknown. 2Several cross-sectional studies link OSA to arterial hypertension, a major risk factor for fatal and nonfatal cardiovascular events. [6][7][8][9][10] However, the association between OSA and increased rate of incident hypertension has not been observed consistently in prospective studies. 11,12 A relatively short follow-up period (<5 years) and a limited inclusion of patients with severe OSA hinder conclusions regarding the association of OSA with incident hypertension. 11,12 Further more, the contribution of change in body weight over time, a well-established risk factor for both hypertension and OSA, to the development of newonset hyper-tension has not been investigated in patients with OSA. 13 Treatment of OSA eliminates repetitive episodes of hypoxia associated with transient cessation of breathing and stabilizes cardiovascular function. 14 Short-term studies indicate that CPAP use is associated with a reduction in blood pressure in patients with hypertension and OSA. 15 Whether long-term CPAP therapy prevents or reduces the rate of new-onset hypertension in patients with OSA has not been investigated. We hypothesized that OSA is an independent risk factor for the development of new-onset hypertension and that longterm CPAP therapy reduces this risk regardless of change in body weight over time.
Clinical DataDemographic, anthropomet...
