RT Journal Article
SR Electronic
T1 Fixed pressure (FP) versus auto-adjusting continuous positive airway pressure (autoCPAP): Comparison of efficacy in reducing blood pressure, a randomized controlled trial
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P322
VO 42
IS Suppl 57
A1 Jean-Louis Pepin
A1 Jean-Philippe Baguet
A1 Renaud Tamisier
A1 Bruno Lepaulle
A1 François Arbib
A1 Nathalie Arnol
A1 Jean-François Timsit
A1 Patrick Levy
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P322.abstract
AB CPAP alone provides only modest reduction in blood pressure (BP) in obstructive sleep apnea (OSA) patients. Limited data are available on the respective impact of FP versus autoCPAP devices on BP evolution.Objective: To compare efficacy of FP versus autoCPAP in reducing BP.Design: Mono-centre, randomised-controlled (1:1), parallel trial.Interventions: One-week autotitration, then FP (95th percentile) for 4 months versus auto-adjusting CPAP throughout 4 months (6-14 cmH20).Main Outcome Measures: Primary endpoint was the change in office systolic BP. Secondary endpoints included 24-hour BP measurements.Results: 322 OSA participants (Apnea+Hypopnea index: 43±21/h, mean age 57±11 years, 30 % female, mean BMI 31.3±6.6 kg/m2, mean office systolic and diastolic BP 135±17 and 80±10 mmHg) were randomly assigned to FP (n=161) or autoCPAP (n=161). Analysis is presented in Intention to Treat. CPAP compliance did not differ between groups with an overall median CPAP use of 5:1 hours per night. Office systolic BP decreased by 2.2 mmHg (95% CI -5.8/1.4) from baseline to 4 months in the FP group and by 0.4 mmHg (-4.3/3.4) in the autoCPAP group (difference between groups -1.3 mmHg,-4.1/1.5; p=0.365, adjusted for baseline BP values). From baseline to 4 months, 24-hour diastolic BP decreased by 1.7 mmHg (-3.9/0.5) in the FP group and by 0.5 mmHg (-2.3/1.3) in the autoCPAP group (difference between groups -1.4 mmHg, -2.7/-0.01; p=0.0477, adjusted for baseline BP values).Conclusions: Fixed pressure is more effective than autoCPAP in reducing blood pressure.Trial Reg No: NCT01090297.