The effect of CPAP withdrawal on blood pressure in OSA: Data from three randomised-controlled trials
E. I. Schwarz, C. Schlatzer, V. A. Rossi, C. Nowak, K. E. Bloch, J. R. Stradling, M. Kohler (Zurich, Switzerland; Oxford, United Kingdom)
Source: International Congress 2014 – The story continues: impact of OSA on cardiometabolic parameters
Disease area: Sleep and breathing disorders
Abstract Background Based on meta-analyses, the blood pressure (BP) lowering effect of continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA) is reported to be 2mmHg. This figure is derived from trials often limited by poor CPAP compliance, thus, underestimating the effect of CPAP treatment. We analysed BP data from randomised-controlled CPAP withdrawal trials which included only optimally CPAP compliant patients.Methods 145 OSA patients on CPAP were randomised to continue therapeutic (n=62) or to withdraw CPAP (n=83) for two weeks. Morning BP was measured at home before and in hospital after sleep studies.Results CPAP withdrawal was associated with a return of OSA (apnoea-hypopnoea index (AHI) at baseline 2.8/h, at follow-up 33.2/h). Systolic office BP increased in the CPAP withdrawal group compared to CPAP continuation by +6.5mmHg (95%CI 2.6-10.4mmHg, p=0.001) and systolic home BP by +9.7mmHg (95%-CI 6.3-13.0mmHg, p<0.001); diastolic office BP increased by +5.0mmHg (95%CI 2.4-7.6mmHg, p<0.001) and diastolic home BP by +7.9mmHg (95%CI 5.6-10.3mmHg, p<0.001).AHI, baseline systolic BP, statins, gender and number of antihypertensive drugs were independently associated with systolic BP change in multivariate analysis controlled for age, BMI, smoking, diabetes, and sleepiness. Change in diastolic BP was independently predicted by AHI, baseline diastolic BP, and statins.Conclusions Short-term CPAP withdrawal results in a clinically relevant increase in BP, which is considerably higher than in conventional CPAP trials and may be underestimated if only office BP values are used. OSA severity and baseline BP seem to be predictors of BP response to CPAP.
Rating:
You must login to grade this presentation.
Share or cite this content
Citations should be made in the following way:
E. I. Schwarz, C. Schlatzer, V. A. Rossi, C. Nowak, K. E. Bloch, J. R. Stradling, M. Kohler (Zurich, Switzerland; Oxford, United Kingdom). The effect of CPAP withdrawal on blood pressure in OSA: Data from three randomised-controlled trials. Eur Respir J 2014; 44: Suppl. 58, 1740
You must login to share this Presentation/Article on Twitter, Facebook, LinkedIn or by email.
Member's Comments
Related content which might interest you:
Related content which might interest you: