Obstructive Sleep Apnea Patients Who Present With Elevated BP Can Benefit From CPAP Therapy

David W. Hudgel, MD

Director of Sleep Medicine and Research
Henry Ford Hospital
Detroit, MI

Continuous positive airway pressure (CPAP) as treatment for obstructive sleep apnea (OSA) has shown variable size effects on decreases in blood pressure (BP) as well as isolated decreases in systolic, diastolic, nocturnal, and 24-hour mean BP. In the study described here, investigators initially hypothesized that OSA patients who had been diagnosed with more severe hypertension and who demonstrated higher CPAP adherence would show greater BP reductions with CPAP therapy when compared to normotensive or less adherent patients. The study’s singular finding did not conform to this hypothesis, however. Dr. Hudgel et al found that, regardless of previous diagnosis of hypertension or presence of refractory hypertension (ie, use of ≥3 antihypertensives) or level of adherence, the higher the patient’s BP on entry to the trial, the greater the reduction in BP with CPAP treatment. Investigators thus concluded that the BP level at initial presentation is among the most important indicators of potential BP benefit with CPAP administration. In this interview, Dr. Hudgel discusses the possible clinical application of implementing CPAP as an adjunct to antihypertensive treatment for those OSA patients who present with elevated BP.

References

Malik J, Drake CL, Hudgel DW. Variables affecting the change in systemic blood pressure in response to nasal CPAP in obstructive sleep apnea patients. Sleep Breath. 2008;12:47–52.
Borgel J, Sanner BM, Keskin F, et al. Obstructive sleep apnea and blood pressure. Interaction between the blood pressure lowering effects of positive airway pressure therapy and antihypertensive drugs. Am J Hypertens. 2004; 17:1081–1087

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