| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1 Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 2 Sleep Research Laboratories of the Toronto Rehabilitation Institute, 3 Toronto General Hospital/UHN, and 4 Dept of Medicine and the Centre for Sleep and Chronobiology of the University of Toronto, Toronto, ON, Canada
CORRESPONDENCE: T.D. Bradley, NU 9-112, The Toronto General Hospital of the University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada. Fax: 1 4163404197. E-mail: douglas.bradley@utoronto.ca
Keywords: cardiovascular physiology, respiratory physiology, sleep physiology
Received: April 30, 2002
Accepted October 16, 2002
This study was undertaken to determine whether abolition of obstructive sleep apnoea (OSA) by continuous positive airway pressure (CPAP) could reduce blood pressure (BP) in patients with refractory hypertension.
In 11 refractory hypertensive patients with OSA, the acute effects of CPAP on nocturnal BP were studied during sleep and its longer term effects on 24-h ambulatory BP after 2 months.
During a single night's application, CPAP abolished OSA and reduced systolic BP in stage 2 sleep from 138.3±6.8 to 126.0±6.3 mmHg. There was also a trend towards a reduction in average diastolic BP (from 77.7±4.5 to 72.9±4.5). CPAP usage for 2 months was accompanied by an 11.0±4.4 mmHg reduction in 24-h systolic BP. In addition, both the nocturnal and daytime components of systolic BP fell significantly by 14.4±4.4 and 9.3±3.9 mmHg, respectively. Diastolic BP was reduced significantly at night by 7.8±3.0 mmHg.
In patients with refractory hypertension, acute abolition of obstructive sleep apnoea by continuous positive airway pressure reduces nocturnal blood pressure. These data also suggest that continuous positive airway pressure may reduce nocturnal and daytime systolic blood pressure chronically. Randomised trials are needed to confirm the latter results.
This article has been cited by other articles:
|
|
 |
|
  D. A. Calhoun, D. Jones, S. Textor, D. C. Goff, T. P. Murphy, R. D. Toto, A. White, W. C. Cushman, W. White, D. Sica, et al. Resistant Hypertension: Diagnosis, Evaluation, and Treatment: A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research Circulation, June 24, 2008; 117(25): e510 - e526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Calhoun, D. Jones, S. Textor, D. C. Goff, T. P. Murphy, R. D. Toto, A. White, W. C. Cushman, W. White, D. Sica, et al. Resistant Hypertension: Diagnosis, Evaluation, and Treatment: A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research Hypertension, June 1, 2008; 51(6): 1403 - 1419. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Campos-Rodriguez, J. Perez-Ronchel, A. Grilo-Reina, J. Lima-Alvarez, M. A. Benitez, and C. Almeida-Gonzalez Long-term Effect of Continuous Positive Airway Pressure on BP in Patients With Hypertension and Sleep Apnea Chest, December 1, 2007; 132(6): 1847 - 1852. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Floras and T. D. Bradley Treating Obstructive Sleep Apnea: Is There More to the Story Than 2 Millimeters of Mercury? Hypertension, August 1, 2007; 50(2): 289 - 291. [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Montserrat, F. Garcia-Rio, and F. Barbe Diagnostic and Therapeutic Approach to Nonsleepy Apnea Am. J. Respir. Crit. Care Med., July 1, 2007; 176(1): 6 - 9. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Martinez-Garcia, R. Gomez-Aldaravi, J-J. Soler-Cataluna, T. G. Martinez, B. Bernacer-Alpera, and P. Roman-Sanchez Positive effect of CPAP treatment on the control of difficult-to-treat hypertension Eur. Respir. J., May 1, 2007; 29(5): 951 - 957. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. N. Pratt-Ubunama, M. K. Nishizaka, R. L. Boedefeld, S. S. Cofield, S. M. Harding, and D. A. Calhoun Plasma Aldosterone Is Related to Severity of Obstructive Sleep Apnea in Subjects With Resistant Hypertension Chest, February 1, 2007; 131(2): 453 - 459. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. T. McNicholas, M. R. Bonsignore, and the Management Committee of EU COST ACTION B26 Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities Eur. Respir. J., January 1, 2007; 29(1): 156 - 178. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. P. Papadopoulos and V. Papademetriou Resistant Hypertension: Diagnosis and Management Journal of Cardiovascular Pharmacology and Therapeutics, June 1, 2006; 11(2): 113 - 118. [Abstract] [PDF]
|
|
|
|
|
|
F. Iellamo and N. Montano Continuous Positive Airway Pressure Treatment: Good for Obstructive Sleep Apnea Syndrome, Maybe Not for Hypertension? Chest, June 1, 2006; 129(6): 1403 - 1405. [Full Text] [PDF]
|
|
|
|
|
|
F. Campos-Rodriguez, A. Grilo-Reina, J. Perez-Ronchel, M. Merino-Sanchez, M. A. Gonzalez-Benitez, M. Beltran-Robles, and C. Almeida-Gonzalez Effect of Continuous Positive Airway Pressure on Ambulatory BP in Patients With Sleep Apnea and Hypertension: A Placebo-Controlled Trial Chest, June 1, 2006; 129(6): 1459 - 1467. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Norman, J. S. Loredo, R. A. Nelesen, S. Ancoli-Israel, P. J. Mills, M. G. Ziegler, and J. E. Dimsdale Effects of Continuous Positive Airway Pressure Versus Supplemental Oxygen on 24-Hour Ambulatory Blood Pressure Hypertension, May 1, 2006; 47(5): 840 - 845. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Bonsignore, G. Parati, G. Insalaco, P. Castiglioni, O. Marrone, S. Romano, A. Salvaggio, G. Mancia, G. Bonsignore, and M. Di Rienzo Baroreflex control of heart rate during sleep in severe obstructive sleep apnoea: effects of acute CPAP Eur. Respir. J., January 1, 2006; 27(1): 128 - 135. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. I. Pack Advances in Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., January 1, 2006; 173(1): 7 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Campos-Rodriguez, N. Pena-Grinan, N. Reyes-Nunez, I. De la Cruz-Moron, J. Perez-Ronchel, F. De la Vega-Gallardo, and A. Fernandez-Palacin Mortality in Obstructive Sleep Apnea-Hypopnea Patients Treated With Positive Airway Pressure Chest, August 1, 2005; 128(2): 624 - 633. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. O'Driscoll, K. Kostikas, A. K. Simonds, and M. J. Morrell Occlusion of the upper airway does not augment the cardiovascular response to arousal from sleep in humans J Appl Physiol, April 1, 2005; 98(4): 1349 - 1355. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Feinsilver A Sleeping Giant: Sleep-Disordered Breathing in the Coronary Care Unit Chest, January 1, 2005; 127(1): 4 - 5. [Full Text] [PDF]
|
|
|
|
|
|
M. A. Skinner, M. S. Choudhury, S. D.R. Homan, J. O. Cowan, G. T. Wilkins, and D. R. Taylor Accuracy of Monitoring for Sleep-Related Breathing Disorders in the Coronary Care Unit Chest, January 1, 2005; 127(1): 66 - 71. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G V Robinson, J R Stradling, and R J O Davies Sleep {middle dot} 6: Obstructive sleep apnoea/hypopnoea syndrome and hypertension Thorax, December 1, 2004; 59(12): 1089 - 1094. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. O'Driscoll, G. E. Meadows, D. R. Corfield, A. K. Simonds, and M. J. Morrell Cardiovascular response to arousal from sleep under controlled conditions of central and peripheral chemoreceptor stimulation in humans J Appl Physiol, March 1, 2004; 96(3): 865 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Fietze, D. Romberg, M. Glos, S. Endres, H. Theres, C. Witt, and V. K. Somers Effects of positive-pressure ventilation on the spontaneous baroreflex in healthy subjects J Appl Physiol, March 1, 2004; 96(3): 1155 - 1160. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. M. Shamsuzzaman, B. J. Gersh, and V. K. Somers Obstructive Sleep Apnea: Implications for Cardiac and Vascular Disease JAMA, October 8, 2003; 290(14): 1906 - 1914. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
