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Sleep Disorders |

The Effect of Long Term CPAP Treatment on Blood Pressure in Patients With Obstructive Sleep Apnea Syndrome and Hypertension - Sphygmomanometer Measurement Versus Ambulatory Blood Pressure Monitoring

Oana Deleanu, PhD; Andra Malaut, MD; Anca Donoaica, MD; Oana Arghir, PhD; Florin Mihaltan, PhD
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University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania


Chest. 2013;144(4_MeetingAbstracts):994A. doi:10.1378/chest.1704373
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Abstract

SESSION TITLE: Sleep Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Obstructive sleep apnea (OSAS) is the first causes of secondary hypertension (HT). Some studies regarding effect of CPAP treatment on blood pressure (BP) in patients with association of OSA and HT showed a small but statistically significant reduction of BP; most of them are based on sphyngomanometer measurements and studied the effect after a short period of using CPAP. The authors proposed to study long term variation of blood pressure (BP) under CPAP in patients with treated HT and OSAS, comparing methods: sphygmomanometer (SM) and ambulatory blood pressure monitor (ABPM) for 24h.

METHODS: We applied exclusion criteria (central/mixed apnea/hypoventilation syndromes, respiratory dysfunction, another secondary HT, changing treatment during study, CPAP failure) to 96 patients with OSA and treated HT. We studied 30 patients. BP monitoring was made with SM and with ABPM: at diagnostic, after 3 and 6 months of CPAP use.

RESULTS: 22 patients with controlled HT (73.3%), 8 with resistant HT (26.7%), 24 (80%) men and 6 (20%) women. Systolic BP (SBP) measured with SM was significantly lower after 3 months (143.0±11.3 vs. 129.9±15.1mmHg, p=0.012), with a trend of increasing at 6 months (137.0±15. 7mmHg, p=NS); mean SBP measured with ABPM had a trend of decrease at 3 months (148.6±19.3 vs. 140.7±19.1mmHg, p=NS) and to be greater at 6 months (152.8±22. 9mmHg, p=NS). The same trend was observed in diastolic BP: measured with SM were significant lower (82.3±10.8 vs. 68. 7±7.4mmHg, p<0.001 after 3 months; vs. 72.0±7.9mmHg, p=0.017 after 6 months), but without any significance when measured with ABPM (82.6±11.6vs 78.3±11.2mmHg, p=NS after 3 months; vs. 83.4±12.9mmHg, p=NS after 6 months).

CONCLUSIONS: Most of the literatures reporting differences in BP values were based on sphygmomanometer measurements, which excluded nocturnal values of BP. To establish with certainty the decrease of BP after CPAP treatment, the measuring method is extremely important.

CLINICAL IMPLICATIONS: It is important to determine in OSAS patients which BP measuring method is more reliable in terms of cardiovascular risk.

DISCLOSURE: The following authors have nothing to disclose: Oana Deleanu, Andra Malaut, Anca Donoaica, Oana Arghir, Florin Mihaltan

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