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

Objective To assess the effect of continuous positive airway pressure (CPAP) on 24 hour ambulatory blood pressure monitoring values in a large number of patients with untreated systemic hypertension of new onset and obstructive sleep apnoea. Design Multicentre, double blind, randomised, placebo cont...

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Authors: Durán-Cantolla, Joaquín, Aizpuru, Felipe, Montserrat, José María, Ballester, Eugeni, Terán-Santos, Joaquin, Aguirregomoscorta, Jose Ignacio, González Martínez, Mónica|||0000-0003-1516-0181, Lloberes, Patricia, Masa, Juan Fernando, Peña, Mónica de la, Carrizo, Santiago, Mayos, Mercedes, Barbé, Ferrán
Format: article
Publication Date:2010
Country:España
Institution:Universidad de Cantabria (UC)
Repository:UCrea Repositorio Abierto de la Universidad de Cantabria
Language:English
OAI Identifier:oai:repositorio.unican.es:10902/33000
Online Access:https://hdl.handle.net/10902/33000
Access Level:Open access
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spelling Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trialDurán-Cantolla, JoaquínAizpuru, FelipeMontserrat, José MaríaBallester, EugeniTerán-Santos, JoaquinAguirregomoscorta, Jose IgnacioGonzález Martínez, Mónica|||0000-0003-1516-0181Lloberes, PatriciaMasa, Juan FernandoPeña, Mónica de laCarrizo, SantiagoMayos, MercedesBarbé, FerránObjective To assess the effect of continuous positive airway pressure (CPAP) on 24 hour ambulatory blood pressure monitoring values in a large number of patients with untreated systemic hypertension of new onset and obstructive sleep apnoea. Design Multicentre, double blind, randomised, placebo controlled trial. Setting Eleven general hospitals in Spain between 2004 and 2007. Participants 340 patients recently diagnosed as having systemic hypertension by a general practitioner (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or both) and an apnoea-hypopnoea index per hour of sleep of >15 events/hour. Intervention Patients were assigned to CPAP (n=169) or sham CPAP (n=171) for three months. Main outcome measurements Net changes in the different 24 hour ambulatory blood pressure monitoring values from baseline to three months of optimal or sham CPAP. Results 277 (81%) of the 340 patients randomised were men; the patients had a mean age of 52.4 (SD 10.5) years, a body mass index of 31.9 (5.7), an Epworth sleepiness scale score of 10.1 (4.3), an apnoea-hypopnoea index of 43.5 (24.5). No differences between groups were seen at baseline. Compared with placebo and analysed by intention to treat, the mean 24 hour ambulatory blood pressure of the CPAP group decreased by 1.5 (95% confidence interval: 0.4 to 2.7) mm Hg (P=0.01). The mean 24 hour ambulatory blood pressure monitoring measures decreased by 2.1 mm Hg (0.4 to 3.7) mm Hg (P=0.01) for systolic pressure and 1.3 (0.2 to 2.3) mm Hg (P=0.02) for diastolic blood pressure. Mean nocturnal blood pressure decreased by 2.1 (0.5 to 3.6) mm Hg (P=0.01). Conclusions CPAP produced a statistically significant reduction in blood pressure in patients with systemic hypertension and obstructive sleep apnoea. This reduction is small and did not achieve the 3 mm Hg drop in mean 24 hour ambulatory blood pressure that the trial was powered to detect. Consequently, these results may have uncertain clinical relevance. However, taking into account the prevalence of hypertension and the likelihood of comorbidities, the decrease in blood pressure, although minimal, may be beneficial.Funding: The study was sponsored by the Spanish Ministry of Health (PI041110), the Basque Government’s Department of Health (20031103), and the Spanish Respiratory Society (SEPAR 2005). The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, and approval of the manuscript. The opinions, results, and conclusions are those of the authors.BMJ Publishing Group LtdUniversidad de Cantabria20102010-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttps://hdl.handle.net/10902/33000BMJ, 2010, 341, c5991reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/330002026-06-02T12:39:31Z
dc.title.none.fl_str_mv Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial
title Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial
spellingShingle Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial
Durán-Cantolla, Joaquín
title_short Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial
title_full Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial
title_fullStr Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial
title_full_unstemmed Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial
title_sort Continuous positive airway pressure as treatment for systemic hypertension in people with obstructive sleep apnoea: randomised controlled trial
dc.creator.none.fl_str_mv Durán-Cantolla, Joaquín
Aizpuru, Felipe
Montserrat, José María
Ballester, Eugeni
Terán-Santos, Joaquin
Aguirregomoscorta, Jose Ignacio
González Martínez, Mónica|||0000-0003-1516-0181
Lloberes, Patricia
Masa, Juan Fernando
Peña, Mónica de la
Carrizo, Santiago
Mayos, Mercedes
Barbé, Ferrán
author Durán-Cantolla, Joaquín
author_facet Durán-Cantolla, Joaquín
Aizpuru, Felipe
Montserrat, José María
Ballester, Eugeni
Terán-Santos, Joaquin
Aguirregomoscorta, Jose Ignacio
González Martínez, Mónica|||0000-0003-1516-0181
Lloberes, Patricia
Masa, Juan Fernando
Peña, Mónica de la
Carrizo, Santiago
Mayos, Mercedes
Barbé, Ferrán
author_role author
author2 Aizpuru, Felipe
Montserrat, José María
Ballester, Eugeni
Terán-Santos, Joaquin
Aguirregomoscorta, Jose Ignacio
González Martínez, Mónica|||0000-0003-1516-0181
Lloberes, Patricia
Masa, Juan Fernando
Peña, Mónica de la
Carrizo, Santiago
Mayos, Mercedes
Barbé, Ferrán
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
description Objective To assess the effect of continuous positive airway pressure (CPAP) on 24 hour ambulatory blood pressure monitoring values in a large number of patients with untreated systemic hypertension of new onset and obstructive sleep apnoea. Design Multicentre, double blind, randomised, placebo controlled trial. Setting Eleven general hospitals in Spain between 2004 and 2007. Participants 340 patients recently diagnosed as having systemic hypertension by a general practitioner (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or both) and an apnoea-hypopnoea index per hour of sleep of >15 events/hour. Intervention Patients were assigned to CPAP (n=169) or sham CPAP (n=171) for three months. Main outcome measurements Net changes in the different 24 hour ambulatory blood pressure monitoring values from baseline to three months of optimal or sham CPAP. Results 277 (81%) of the 340 patients randomised were men; the patients had a mean age of 52.4 (SD 10.5) years, a body mass index of 31.9 (5.7), an Epworth sleepiness scale score of 10.1 (4.3), an apnoea-hypopnoea index of 43.5 (24.5). No differences between groups were seen at baseline. Compared with placebo and analysed by intention to treat, the mean 24 hour ambulatory blood pressure of the CPAP group decreased by 1.5 (95% confidence interval: 0.4 to 2.7) mm Hg (P=0.01). The mean 24 hour ambulatory blood pressure monitoring measures decreased by 2.1 mm Hg (0.4 to 3.7) mm Hg (P=0.01) for systolic pressure and 1.3 (0.2 to 2.3) mm Hg (P=0.02) for diastolic blood pressure. Mean nocturnal blood pressure decreased by 2.1 (0.5 to 3.6) mm Hg (P=0.01). Conclusions CPAP produced a statistically significant reduction in blood pressure in patients with systemic hypertension and obstructive sleep apnoea. This reduction is small and did not achieve the 3 mm Hg drop in mean 24 hour ambulatory blood pressure that the trial was powered to detect. Consequently, these results may have uncertain clinical relevance. However, taking into account the prevalence of hypertension and the likelihood of comorbidities, the decrease in blood pressure, although minimal, may be beneficial.
publishDate 2010
dc.date.none.fl_str_mv 2010
2010-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10902/33000
url https://hdl.handle.net/10902/33000
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMJ Publishing Group Ltd
publisher.none.fl_str_mv BMJ Publishing Group Ltd
dc.source.none.fl_str_mv BMJ, 2010, 341, c5991
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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