Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial

Durán-Cantolla, Joaquín; Aizpuru, Felipe; Montserrat, Josep M.; Ballester, Eugeni; Terán-Santos, Joaquín; Aguirregomoscorta, Jose Ignacio; González, Mónica; Lloberes, Patrícia; Masa, Juan F.; Peña, Mónica de la; Carrizo, Santiago; Mayos, Mercedes; Barbé, Ferrán; Sleep, Spanish

doi:10.1136/bmj.c5991

Cited by 232 publications

(152 citation statements)

References 51 publications

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“…In our study, the participants used CPAP continuously (except for rare bathroom breaks) in the laboratory during the entire duration of the time in bed (i.e., from 11:00 P.M. to 7:00 A.M.), which is comparable with approximately 8 hours of nightly objective CPAP adherence downloaded from devices in a clinical setting. Our finding that CPAP treatment reduces systolic and diastolic blood pressure as compared with placebo is consistent with prior randomized trials showing beneficial effects of CPAP on blood pressure in OSA patients (25,28,(39)(40)(41)(42). Most of our participants (z80%) were not hypertensive at baseline.…”

Section: Original Articlesupporting

confidence: 90%

“…Most of our participants (z80%) were not hypertensive at baseline. Although the average decrease in blood pressure seems to be larger in our study as compared with the treatment effect in prior trials (28,(39)(40)(41)(42), it has been reported that the effectiveness of CPAP in reducing blood pressure increases with higher adherence to treatment (28,(41)(42)(43). Within the CPAP group, we observed significant decreases in 24-hour and daytime diastolic blood pressure, whereas the nighttime systolic and diastolic blood pressure seemed to be higher after treatment, although these nighttime changes did not reach statistical significance.…”

Section: Original Articlecontrasting

confidence: 74%

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Eight Hours of Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Patients with Prediabetes. A Randomized Controlled Trial

Pamidi

Wroblewski²,

Stępień

et al. 2015

Am J Respir Crit Care Med

160

119

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Rationale: Although obstructive sleep apnea (OSA) is associated with impaired glucose tolerance and diabetes, it remains unclear whether OSA treatment with continuous positive airway pressure (CPAP) has metabolic benefits.Objectives: To determine the effect of 8-hour nightly CPAP treatment on glucose metabolism in individuals with prediabetes and OSA.Methods: In a randomized controlled parallel group study, 39 participants were randomly assigned to receive either 8-hour nightly CPAP (n = 26) or oral placebo (n = 13). Sleep was polysomnographically recorded in the laboratory on each night. CPAP adherence was ensured by continuous supervision. Participants continued their daily routine activities outside the laboratory. Glucose metabolism was assessed at baseline and after 2 weeks of assigned treatment using both the oral and intravenous glucose tolerance tests. The primary outcome was the overall glucose response as quantified by the area under the curve for glucose during 2-hour oral glucose tolerance testing. Secondary outcomes included fasting and 2-hour glucose and insulin, the area under the curves for insulin and insulin secretion, norepinephrine, insulin sensitivity, acute insulin response to glucose, and 24-hour blood pressure.

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Section: Original Articlesupporting

confidence: 90%

Section: Original Articlecontrasting

confidence: 74%

Eight Hours of Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Patients with Prediabetes. A Randomized Controlled Trial

Pamidi

Wroblewski²,

Stępień

et al. 2015

Am J Respir Crit Care Med

160

119

View full text Add to dashboard Cite

show abstract

“…Probably CPAP therapy for one night decreased blood pressure by reducing the acute hemodynamic changes associated with reduced NO production. In addition to restoring the normal nocturnal "dipping" pattern CPAP treatment has also reduced daytime blood pressure in a few studies [9]. Since even small decrease in arterial pressure can contribute to reducing cardiovascular disease risk in such patients.…”

Section: Resultsmentioning

confidence: 99%

“…It appears to be beneficial in improving the cardiovascular and metabolic outcomes in such patients [8]. Many studies have shown a reduction in blood pressure with CPAP treatment [9] whereas there are conflicting results on the effect of CPAP on other components of metabolic syndrome like insulin resistance [10] and lipid profile [11]. Thus, the effect of CPAP on the components of metabolic syndrome in OSA still remains ambiguous.…”

Section: Introductionmentioning

confidence: 99%

Effect of Short Term C PAP Therapy in Obstructive Sleep Apnea Patients with Metabolic Syndrome

Kanimozhi

Chilukuri

Saravanan

et al. 2015

JCDR

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Background: Patients of obstructive sleep apnea (OSA) with metabolic syndrome (MetS) are at increased risk of cardiovascular morbidity and mortality. The role of oxidative stress in pathogenesis of OSA and MetS has been widely reported. Continuous positive airway pressure (CPAP) therapy remains the first-line of treatment in OSA. The beneficial effect of long term CPAP therapy in OSA is well-known. However, the effect of short term CPAP on the components of MetS and oxidative stress-antioxidant levels is still unclear.Aim: The present study explored the effects of one night of CPAP therapy on the oxidant-antioxidant status and components of MetS in patients of OSA with MetS.

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“…2 Several trials have indicated that treatment of OSAS can lead to reductions in hypertension and prehypertension. [3][4][5] The question then arises of how this is best accomplished. Diagnosis of obstructive sleep apnea (OSA) can be limited by availability, accessibility, and the cost of in-laboratory polysomnography: the gold standard for diagnosis.…”

mentioning

confidence: 99%

Screening for Severe Obstructive Sleep Apnea Syndrome in Hypertensive Outpatients

Marcus

Bisognano

2013

J of Clinical Hypertension

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Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial

Cited by 232 publications

References 51 publications

Eight Hours of Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Patients with Prediabetes. A Randomized Controlled Trial

Eight Hours of Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Patients with Prediabetes. A Randomized Controlled Trial

Effect of Short Term C PAP Therapy in Obstructive Sleep Apnea Patients with Metabolic Syndrome

Screening for Severe Obstructive Sleep Apnea Syndrome in Hypertensive Outpatients

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