Abstract
Introduction: Continuous positive airway pressure (CPAP) has a heterogeneous effect on blood pressure (BP) in hypertensive patients. However, the effect of CPAP on BP in hypertensive subjects regarding to circadian BP pattern has never been explored. This study aimed to assess the effect of CPAP on BP considering the circadian BP pattern in untreated hypertensive patients.
Methods: This study is a post hoc analysis of the Spanish Cohort for the Study of the Effect of CPAP in Hypertension (CEPECTA), a multicentre, randomized trial of CPAP versus sham-CPAP in patients with new-onset systemic hypertension and an apnea/hypopnea index >15 events/h. We included patients for whom 24-h ambulatory BP monitoring (ABPM) data were available at baseline and 12 weeks after the intervention. Subjects were classified based on the dipping ratio (dipper/nondipper). We evaluated the effect of CPAP on ABPM parameters after 12 weeks of treatment.
Results: Overall, 272 hypertensive subjects were included in the analysis (113 dippers/159 nondippers). Baseline clinical and polysomnographic variables were similar between the groups. CPAP treatment in nondipper patients was associated with reductions in 24-h ambulatory BP variables and nighttime ambulatory BP measurements. However, a nonsignificant effect was reported in the dipper group. The differential effects of CPAP between the groups were -2·99 mmHg (-5·92 to -0·06) for the mean 24-h ambulatory BP and -5·35 mmHg (-9·01 to -1·69) for the mean nighttime ambulatory BP.
Conclusions: Our results show a differential effect of CPAP treatment on BP in hypertensive patients depending on the circadian pattern. Only nondipper patients benefited from CPAP treatment in terms of BP reduction.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Barbé has nothing to disclose.
Conflict of interest: Dr. Benitez has nothing to disclose.
Conflict of interest: Dr. Dalmases has nothing to disclose.
Conflict of interest: Dr. Durán-Cantolla has nothing to disclose.
Conflict of interest: Dr. Egea has nothing to disclose.
Conflict of interest: Dr. Sanchez-de-la-Torre has nothing to disclose.
Conflict of interest: Dr. Santamaria-Martos has nothing to disclose.
Conflict of interest: Dr. Sapiña-Beltran has nothing to disclose.
Conflict of interest: Dr. Torres has nothing to disclose.
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