Antihypertensive Effects of Continuous Airway Positive Pressure Plus Antihypertensive Drugs on OSAHS Patients with Hypertension_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Junjian , CHEN Baoyuan , DONG LiXia.

Department of Respiratory Medicine, TianjinMedical University General Hospital. Tianjin,300052, ChinaCorresponding Author: CHEN Bao-yuan, E-mail: cbynew@ yahoo. com. cn;

Corresponding author：

Keywords：

Obstructive sleep apnea hypopnea syndrome; Hypertension; Antihypertensive medicine; Continuous airway positive pressure; 24-hour blood pressure monitoring

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Objective To investigate the antihypertensive effects of continuous airway positive pressure( CPAP) plus antihypertensive drugs on patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) and hypertension.Methods 82 OSAHS patients with hypertension were enrolled in this study. They were randomly divided into a CPAP treatment group( 44 patients, treated with antihypertensive drugs and CPAP) , and a control group( 38 patients, treated with antihypertensive drugs only) . All the patients were performed polysomnography and 24-hour blood pressure monitoring before and 12 weeks after the treatment. Results After 12 weeks treatment, except the systolic pressure in night time( nSBP) , all the parameters of 24-hour blood monitoring improved better in the CPAP group than in the control group( all P lt; 0. 05) . The blood pressure dropped to normal in 75. 0% ( 33/44) CPAP patients and in 52. 6% ( 20 /38) control patients. In the CPAP group, 8( 18. 2% ) cases were withdrawn from antihypertensive drugs, 13( 29. 5% )cases required single agents, and 9( 20. 5% ) cases required three agents to achieve blood pressure control.
But in the control group, all the patients needed two or more antihypertensive agents, in which 23( 60. 6% )patients needed three agents to achieve blood pressure control. After the treatment, the patients with dipping pattern blood pressure increased from10 to 29( 22. 7% -65. 9% , P lt;0. 05) in the CPAP group, and from10
to 14( 26. 3% -36. 8%, P gt;0. 05) in the control group. Conclusions Combination therapy with CPAP and antihypertensive drugs controls blood pressure better than antihypertensive medication only for OSAHS patients with hypertension with fewer types of antihypertensive agents or even withdrawal from antihypertensive medication in some patients.

Citation： WANG Junjian,CHEN Baoyuan,DONG LiXia.. Antihypertensive Effects of Continuous Airway Positive Pressure Plus Antihypertensive Drugs on OSAHS Patients with Hypertension. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(3): 246-248. doi: Copy

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7.	李莉, 武海英, 刘力生. 睡眠呼吸暂停综合征与高血压治疗. 中华心血管病杂志, 2004, 32: 30-32.
8.	Sayk F, Becker C, Teckentrup C, et al. To dip or not to dip: on the physiology of blood pressure decrease during nocturnal sleep in healthy humans. Hypertension, 2007, 49: 1070-1076.
9.	冯靖, 陈宝元, 崔林阳, 等. 不同频率间歇低氧暴露后兔颈动脉体的炎症状态和窦神经传入活性. 中华结核和呼吸杂志, 2008 ,31: 670-674 .
10.	Rey S, Valdés G, Iturriaga R. Pathophysiology of obstructive sleep apnea-associated hypertension. Rev Med Chil,2007, 135: 1333-1342.

1. Somers VK, White DP, Amin R, et al. Sleep apnea and cardiovascular disease: : an AHA/ACCF. expert consensus docment. Circulation, 2008, 118 : 1080 -1111 .
2. Bazzano LA, Khan Z, Reynolds K, et al. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension, 2007, 50: 417-23.
3. 中华医学会呼吸疾病学分会睡眠呼吸疾病学组. 阻塞性睡眠呼吸暂停低通气综合征诊治指南( 草案) . 中华内科杂志, 2003 ,42: 594-597 .
4. 中国高血压防治指南修订委员会. 中国高血压防治指南. 中国卒中杂志, 2006, 1 : 654-664.
5. Silverberg DS, Oksenberg A, Iaina A. Sleep-related breathing disorders as a major cause of essential hypertension: fact or fiction?Curr Opin Nephrol Hypertens, 1998 , 7: 353-357 .
6. Logan A. Sleep-disordered breathing and hypertension. Am JRespir Crit Care Med, 2009, 179: 1082-1083.
7. 李莉, 武海英, 刘力生. 睡眠呼吸暂停综合征与高血压治疗. 中华心血管病杂志, 2004, 32: 30-32.
8. Sayk F, Becker C, Teckentrup C, et al. To dip or not to dip: on the physiology of blood pressure decrease during nocturnal sleep in healthy humans. Hypertension, 2007, 49: 1070-1076.
9. 冯靖, 陈宝元, 崔林阳, 等. 不同频率间歇低氧暴露后兔颈动脉体的炎症状态和窦神经传入活性. 中华结核和呼吸杂志, 2008 ,31: 670-674 .
10. Rey S, Valdés G, Iturriaga R. Pathophysiology of obstructive sleep apnea-associated hypertension. Rev Med Chil,2007, 135: 1333-1342.

Chinese Journal of Respiratory and Critical Care Medicine

Antihypertensive Effects of Continuous Airway Positive Pressure Plus Antihypertensive Drugs on OSAHS Patients with Hypertension

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