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Respiratory/Sleep

CPAP Linked to Improvement in Resistant Hypertension

November 11, 2013

SAO PAULO, BRAZIL – A report in MedPage Today summarizes a small study in which researchers concluded that the use of CPAP in patients with resistant hypertension and OSA significantly lowered daytime blood pressure.

After 6 months of treatment, a randomized trial showed that those who received CPAP plus medical therapy had an average ambulatory blood pressure reduction of 6.5/4.5 mm Hg, compared with an average increase of 3.1/2.1 mm Hg for those who received medical therapy alone.

According to Geraldo Lorenzi-Filho, MD, PhD, of the Heart Institute at the Universidade de São Paulo, Brazil, and colleagues, the blood pressure changes occurred only when the patients were awake.

As originally reported in the November issue of CHEST, the impact of CPAP on blood pressures in these patients with confirmed resistant hypertension and moderate-to-severe OSA was in the range of that expected from treating other causes of secondary hypertension.

“The importance of our findings is highlighted by the fact that OSA is extremely common among patients with resistant hypertension and is largely underrecognized,” they wrote. “Future studies are necessary to clarify the impact of the treatment of OSA on other cardiovascular outcomes, such as target-organ damage, in patients with resistant hypertension.”

Based on prior research, the magnitude of blood pressure reduction achieved with CPAP in the trial would be expected to reduce cerebrovascular events by more than 30% and cardiovascular events by more than 20%, Malcolm Kohler, MD, of University Hospital Zurich, and John R. Stradling, MD, from the NIHR Biomedical Research Centre in Oxford, England, noted in an accompanying editorial.