On 25 July 2022, the Continuing Professional Development (CPD) Special Interest Group of the Association for Medical Education in Europe came together to open up discussions during a live webinar on ‘ Exploring the Evolution of CPD ’. The objective was to bring together global medical educators to consider perspectives of CPD from the role of global lifelong learners, the role of educators and the role of education providers and health regulators. The landscape of CPD is evolving, and the roles of each key player must include specific actions for facilitated change. Delivering competency outcomes-based learning, fit for purpose, to lifelong learners in health will require (1) learner agency, (2) leadership from educators and (3) providers of lifelong learning to come together to improve delivery of CPD that leads to meaningful change in practice care delivery.
Background: Obstructive sleep apnea (OSA) is an important risk factor for elevated blood pressure (BP), especially in patients with resistant hypertension. Metaanalyses showed decrease of maximum 10 mmHg in BP after continuous positive airway pressure (CPAP). Case Report: A 42-year-old female patient, obese, presented for dyspnea with moderate exertion, daytime sleepiness, snoring, insomnia, tingling in the legs. She has a long history of hypertension (maximum known BP=220/100 mmHg), with progressive increase in medication; BP values are currently uncontrolled with 5 antihypertensive agents hypertension, some causes of resistant hypertension were excluded. The patient underwent polysomnography (PSG), which revealed fragmented sleep (sleep effi ciency= 61%), severe OSA with apnea hypopnea index (AHI) of 45/h, minimum oxygen saturation (minSaO 2) of 65%, periodic leg movements during sleep index (PLMS) of 108/h. Ambulatory blood pressure monitoring (ABPM) report showed medium BP of 181/99/24h, non-dipper. Sleep architecture under CPAP treatment was restructured (sleep effi ciency 78%), with correction of respiratory events at pressure of 11 cm H 2 O (residual AHI=2.1/h, minSaO 2 =93%), less ample periodic leg movements, PLMS index 80/h. The patient followed CPAP treatment for 1 year, with no changes in antihipertensive regimen or lifestyle. After 1 year of CPAP, patient reported none of the previous symptoms and ABPM report showed medium BP of 148/88/24h, dipper. Conclusion: CPAP not only controlled OSA and metabolic consequences, but also determined a signifi cant drop in BP values after 1 year of compliant use.
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