Effect of Celiprolol Treatment in Hypertensive Patients with Sleep Apnea

Planès, Carole; Foucher, A.; Leroy, M; Dartois, Nathalie; Juste, Katherine; Baillart, Olivier; Raffestin, Bernadette

doi:10.1093/sleep/22.4.507

Cited by 31 publications

(15 citation statements)

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“…166 Cilazapril, an angiotensin-converting enzyme inhibitor, had no effect on the AHI but lowered BP during sleep, 167 whereas celiprolol, a ␤-blocker, decreased daytime BP but had relatively little effect during the night. 168 A comparison of the effects of 5 commonly used antihypertensive drugs (atenolol, amlodipine, enalapril, losartan, and hydrochlorothiazide) on BP and sleep architecture 169 showed no effect on the severity of the sleep apnea. The drugs had similar effects on daytime BP, although atenolol reduced the nocturnal pressure slightly more than the other drugs.…”

Section: Treatment Of Osa: Effects On Hypertensionmentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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Section: Treatment Of Osa: Effects On Hypertensionmentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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“…This computerised index was specifically designed to assess BP variability during sleep in patients with sleepdisordered breathing, as it can be computed even during nonstationary periods of varying durations. It reflected short-term variability of BP since all the BP changes computed lasted v20 s and were influenced by sleep fragmentation [12,26]. However, a difference in OSAS severity could not account for the difference between the normotensive and hypertensive groups as both populations had comparable AHI, arousal index and sleep structure.…”

Section: Discussionmentioning

confidence: 99%

Exacerbation of sleep-apnoea related nocturnal blood-pressure fluctuations in hypertensive subjects

Planès¹,

Leroy²,

Fayet³

et al. 2002

European Respiratory Journal

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Obstructive sleep apnoea syndrome (OSAS) induces marked haemodynamic fluctuations during sleep that might be deleterious to the cardiovascular system. The influence of daytime blood pressure (BP) levels and aging on short-term BP variability during sleep in OSAS patients was investigated.Twenty-nine subjects with newly-diagnosed untreated OSAS were categorised into three groups: normotensive subjects aged v50 yrs (n=10); subjects aged v50 yrs with untreated hypertension (n=8); and normotensive subjects aged w50 yrs (n=11). Beat-bybeat BP was recorded with a Finapres device during polysomnography. The average values ¡ SD of apnoea-related BP elevations and the values of the frequency distribution of all BP variations during sleep were assessed to estimate short-term BP variability.Apnoea-related systolic (or diastolic) BP elevations were significantly greater in hypertensives than in normotensives agedv50 yrs (50.3¡4.88 versus 30.7¡2.14 mmHg, pv0.001), as was the SD of systolic (or diastolic) BP variations during sleep (I9.6¡2.22 versus 11.1¡0.73, pv0.001). Short-term BP variability was not significantly increased in normotensive elderly patients.To conclude, the results suggested that systemic hypertension is associated with a greater exacerbation of short-term variability during sleep in obstructive sleep apnoea syndrome patients. Systemic hypertension (HT) is highly prevalent in patients with obstructive sleep apnoea syndrome (OSAS) [1], and recent epidemiological studies [2][3][4] suggest that this association is not entirely explained by known confounding factors such as obesity, age and sex. It has been speculated that the cardiovascular morbidity of OSAS may, in part, be related to the oscillations in systemic blood pressure (BP) and increases in sympathetic discharges that occur repeatedly during the night [5,6]. Indeed, BP falls in time with inspiratory efforts at the beginning of each obstructive episode and rises abruptly at apnoea termination, reaching a peak during the first postapnoeic breaths. Moreover, whereas in normal subjects sympathetic activity decreases during the night, measurements with microneurographical techniques have shown a progressive increase in sympathetic nerve activity during obstructive apnoea with a peak near the end of apnoea [5,7]. Consequently, the significant decrease in the level and variability of BP normally observed during nonrapid eye movement (NREM) sleep is blunted in OSAS patients [7].In subjects with untreated essential HT, arterial baroreceptor reflex operates at higher pressures and baroreceptor heart-rate reflex has been reported to be decreased [8]. The resulting increase in short-term variability of BP may play a role in the alteration of function and structure of the cardiovascular system, since in subjects with untreated systemic HT, targetorgan damage has been shown to be related not only to the level of 24-h mean intraarterial BP, but also to BP variability [9,10]. As nocturnal BP variability has been reported to be increased in patients with es...

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“…Clonidine has been reported to suppress rapid eye movement (REM) sleep and hence to suppress the apneas occurring during REM, which resulted in lessened nocturnal hypoxemia (166). Cilazapril, an angiotensin-converting enzyme inhibitor, had no effect on the AHI but lowered BP during sleep (167), whereas celiprolol, a ␤-blocker, decreased daytime BP but had relatively little effect during the night (168). A comparison of the effects of 5 commonly used antihypertensive drugs (atenolol, amlodipine, enalapril, losartan, and hydrochlorothiazide) on BP and sleep architecture (169) showed no effect on the severity of the sleep apnea.…”

Section: Treatment Of Hypertension: Effects On Osamentioning

confidence: 99%