The effect of continuous positive airway pressure therapy on blood pressure and arterial stiffness in hypertensive patients with obstructive sleep apnea
The effect of continuous positive airway pressure therapy on blood pressure and arterial stiffness in hypertensive patients with obstructive sleep apnea
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DOI：
10.1007/s11325-013-0926-0
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发表时间：
2014-09-01
影响因子：
2.5
通讯作者：
Karagiannis, Asterios
中科院分区：
文献类型：
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作者：
Kartali, Nikoleta;Daskalopoulou, Euphemia;Karagiannis, Asterios
为探讨持续气道正压通气（CPAP）治疗对高血压合并阻塞性睡眠呼吸暂停（OSA）患者血压和动脉硬度的影响，对38例高血压合并重度OSA患者进行了研究。在基线时和至少3个月不间断CPAP治疗后进行动态血压测量。在这些患者中，我们还测量了19例患者的脉搏波速度（PWV）在基线，CPAP治疗后的第一个晚上和3个月。CPAP治疗使收缩压从141.5 ± 12.1 mmHg降至133.5 ± 9.7 mmHg（p = 0.007），舒张压从87.8 ± 6.8 mmHg降至83 ± 5.4 mmHg（p = 0.004）。CPAP治疗第一晚后，PWV也从8.81 +/- 1.4降至8.18 +/- 1 m/s（p = 0.003），3个月时为7.37 +/- 1 m/s（p = 0.007）。据我们所知，这是第一项研究表明，CPAP治疗高血压合并OSA患者从第一个晚上起就改善了动脉僵硬度，持续使用CPAP至少3个月。还观察到血压降低，尽管血压控制并不总是实现的。
We aimed to evaluate the effect of continuous positive airway pressure (CPAP) therapy on blood pressure (BP) and arterial stiffness in hypertensive patients with obstructive sleep apnea (OSA).We studied 38 hypertensive patients who suffered from severe OSA. Ambulatory BP measurement was performed at baseline and after at least 3 months of uninterrupted CPAP therapy. In 19 of these patients, we also measured pulse wave velocity (PWV) at baseline, after the first night of CPAP therapy and at 3 months. Fifteen normotensive subjects without OSA comprised the control group.CPAP therapy reduced systolic BP from 141.5 +/- 12.1 to 133.5 +/- 9.7 mmHg (p = 0.007) and diastolic BP from 87.8 +/- 6.8 to 83 +/- 5.4 mmHg (p = 0.004). CPAP also reduced the PWV from 8.81 +/- 1.4 to 8.18 +/- 1 m/s after the first night of CPAP therapy (p = 0.003) and to 7.37 +/- 1 m/s at 3 months (p = 0.007).To the best of our knowledge, this is the first study demonstrating that CPAP therapy in hypertensive patients with OSA improves arterial stiffness from the first night and that this favorable effect is maintained for at least 3 months of CPAP use. A reduction in BP was also observed, even though BP control was not always achieved.