Efficacy of continuous positive airway pressure (CPAP) therapy in patients with sleep apnea and resistant hypertension
DOI:
https://doi.org/10.52692/1857-0011.2023.1-75.22Keywords:
telemonitoring, cardiac rehabilitation, telerehabilitationAbstract
CPAP treatment reduction blood pressure levels, degree of reduction in blood pressure levels is similar to those achieved by some antihypertensive drugs, especially in patients with resistant hypertension. There is a positive and linear correlation between the hours of use of CPAP and the reduction in blood pressure levels. CPAP decreases both the sympathetic activity and the level of aldosterone concentration on resistant hypertension patients, and these could constitute some of the pathophysiological action mechanisms involved in this treatment. The treatment and adherence to CPAP therapy along with other antihypertensive medications greatly reduce and prevent high blood pressure, CVD, and stroke.
References
Baguet JP, Barone-Rochette G, Pépin JL. Hypertension and obstructive sleep apnoea syndrome: current perspectives. J Hum Hypertens. 2009;23(7):431–443. [PubMed] [Google Scholar] [Ref list]
Marcus Jonathan A, Pothineni Aravind, Marcus Carolina Z, et al. The role of obesity and obstructive sleep apnea in the pathogenesis and treatment of resistant hypertension. Curr Hypertens Rep. 2014;16(1):411. [PubMed] [Google Scholar]
Gilardini L, Lombardi C, Redaelli G, et al. Effect of continuous positive airway pressure in hypertensive patients with obstructive sleep apnea and high urinary metanephrines. J Hypertens. 2018;36(1):199–204. [PubMed] [Google Scholar] [Ref list]
Kato M, Roberts-Thomson P, Phillips BG, et al. Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation. 2000;102(21):2607–2610. [PubMed] [Google Scholar] [Ref list]
Pinto P, Barbara C, Montserrat JM, et al. Effects of CPAP on nitrate and norepinephrine levels in severe and mild-moderate sleep apnea. BMC Pulm Med. 2013;13:13. [PMC free article] [PubMed] [Google Scholar] [Ref list]
Behan M, Wenninger JM. Sex steroidal hormones and respiratory control. Respir Physiol Neurobiol. 2008;164:213–21. [PMC free article] [PubMed] [Google Scholar] [Ref list]
Shahar E, Redline S, Young T, et al. Hormone replacement therapy and sleep-disordered breathing. Am J Respir Crit Care Med. 2003;167:1186–92. [PubMed] [Google Scholar] [Ref list]
Meta-analysis of effects of obstructive sleep apnea on the renin-angiotensin-aldosterone system. Jin Z-N, Wei Y-X. https://www.ncbi.nlm.nih.gov/pubmed/27403143. J Geriatr Cardiol. 2016;13:333–343. [PMC free article] [PubMed] [Google Scholar] [Ref list]
Shrout Tara, David W Rudy, Michael T Piascik. Hypertension update, JNC8 and beyond. Curr Opin Pharmacol. 2017;33:41–46. [PubMed] [Google Scholar]
Martínez-García M.A., Capote F., Campos-Rodríguez F., Lloberes P., Díaz de Atauri M.J., Somoza M., Masa J.F., González M., Sacristán L., Barbé F., et al. Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: The HIPARCO randomized clinical trial. JAMA. 2013;310:2407–2415. doi: 10.1001/jama.2013.281250. [PubMed] [CrossRef] [Google Scholar] [Ref list]
Lozano L., Tovar J.L., Sampol G., Romero O., Jurado M.J., Segarra A., Espinel E., Río J., Untoria M.D., Lloberes P. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: A randomized, controlled trial. J. Hypertens. 2010;28:2161– 2168. doi: 10.1097/HJH.0b013e32833b9c63. [PubMed] [CrossRef] [Google Scholar] [Ref list]
Ishida K, Kato M, Kato Y, et al. Appropriate use of nasal continuous positive airway pressure decreases elevated c-reactive protein in patients with obstructive sleep apnea. Chest. 2009;136(1):125–129. [PMC free article] [PubMed] [Google Scholar] [Ref list]
Haentjens P, Van Meerhaeghe A, Moscariello A, et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med. 2007;167(8):757– 764. [PubMed] [Google Scholar] [Ref list]
Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet. 2002;359(9302):204–210. [PubMed] [Google Scholar] [Ref list]
Lloberes P., Sampol G., Espinel E., Segarra A., Ramon M.A., Romero O., Ferrer R., Martínez-Garcia M.A., Tovar J.L. A randomized controlled study of CPAP effect on plasma aldosterone concentration in patients with resistant hypertension and obstructive sleep apnea. J. Hypertens. 2014;32:1650–1657. doi: 10.1097/HJH.0000000000000238. [PubMed] [CrossRef] [Google Scholar] [Ref list]
de Souza F., Muxfeldt E.S., Margallo V., Cortez A.F., Cavalcanti A.H., Salles G.F. Effects of continuous positive airway pressure treatment on aldosterone excretion in patients with obstructive sleep apnoea and resistant hypertension: A randomized controlled trial. J. Hypertens. 2017;35:837–844. doi: 10.1097/JH.0000000000001254. [PubMed] [CrossRef] [Google Scholar] [Ref list]
Joyeux-Faure M., Baguet J.P., Barone-Rochette G., Faure P., Sosner P., Mounier-Vehier C., Lévy P., Tamisier R., Pépin J.L. Continuous Positive Airway Pressure Reduces Night-Time Blood Pressure and Heart Rate in Patients with Obstructive Sleep Apnea and Resistant Hypertension: The RHOOSAS Randomized Controlled Trial. Front. Neurol. 2018;9:318. doi: 10.3389/fneur.2018.00318. [PMC free article] [PubMed] [CrossRef] [Google Scholar] [Ref list]
Lei Q., Lv Y., Li K., Ma L., Du G., Xiang Y., Li X. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: A systematic review and meta-analysis of six randomized controlled trials. J. Bras. Pneumol. 2017;43:373–379. doi: 10.1590/s180637562016000000190. [PMC free article] [PubMed] [CrossRef] [Google Scholar] [Ref list]
Ohike Y, Kozaki K, Iijima K, et al. Amelioration of vascular endothelial dysfunction in obstructive sleep apnea syndrome by nasal continuous positive airway pressure--possible involvement of nitric oxide and asymmetric NG, NG-dimethylarginine. Circ J. 2005;69(2):221–226. [PubMed] [Google Scholar] [Ref list]
de Souza F., Muxfeldt E.S., Margallo V., Cortez A.F., Cavalcanti A.H., Salles G.F. Effects of continuous positive airway pressure treatment on aldosterone excretion in patients with obstructive sleep apnoea and resistant hypertension: A randomized controlled trial. J. Hypertens. 2017;35:837–844. doi: 10.1097/JH.0000000000001254. [PubMed] [CrossRef] [Google Scholar] [Ref list]
Linz D., Mancia G., Mahfoud F., Narkiewicz K., Ruilope L., Schlaich M., Kindermann I., Schmieder R.E., Ewen S., Williams B., et al. Renal artery denervation for treatment of patients with self-reported obstructive sleep apnea and resistant hypertension: Results from the Global SYMPLICITY Registry. J. Hypertens. 2017;35:148–153. doi: 10.1097HJH.0000000000001142. [PubMed] [CrossRef] [Google Scholar] [Ref list].
Campos-Rodriguez F., Navarro-Soriano C., ReyesNuñez N., Torres G., Caballero-Eraso C., Lloberes P., Diaz-Cambriles T., Somoza M., Masa J.F., Gonzalez M., et al. Good long-term adherence to continuous positive airway pressure therapy in patients with resistant hypertension and sleep apnea. J. Sleep Res. 2019;28:e12805. doi: 10.1111/jsr.12805. [PubMed] [CrossRef] [Google Scholar] [Ref list]
Navarro-Soriano C., Martínez-García M.A., Torres G., Barbé F., Caballero-Eraso C., Lloberes P., Diaz Cambriles T., Somoza M., Masa J.F., González M., et al. Effect of continuous positive airway pressure in patients with true refractory hypertension and sleep apnea: A post-hoc intention-to-treat analysis of the HIPARCO randomized clinical trial. J. Hypertens. 2019;37:1269–1275. doi: 10.1097/JH.0000000000002053. [PubMed] [CrossRef] [Google Scholar] [Ref list]
Navarro-Soriano C., Martínez-García M.A., Torres G., Barbé F., Caballero-Eraso C., Lloberes P., Cambriles T.D., Somoza M., Masa J.F., González M., et al. Factors associated with the changes from a resistant to a refractory phenotype in hypertensive patients: A Pragmatic Longitudinal Study. Hypertens. Res. 2019;42:1708–1715. doi:10.1038/s41440-019-0285-8. [PubMed] [CrossRef] [Google Scholar]
Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006–14. https://doi.org/10.1093/aje/kws342.
Teramoto S, Kume H, Matsuse T, et al. Oxygen administration improves the serum level of nitric oxide metabolites in patients with obstructive sleep apnea syndrome. Sleep Med. 2003;4(5):403–407. [PubMed] [Google Scholar] [Ref list]
Downloads
Published
License
Copyright (c) 2023 Bulletin of the Academy of Sciences of Moldova. Medical Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
