Post date: May 15, 2015 9:42:54 PM
CPAP treatment could provide a solution to patients suffering from drug-resistant hypertension, according to a recent meta-analysis which looked at a multi-study pool of 300 patients using CPAP for a period between 3 weeks and 6 months. Obstructive sleep apnea has a striking prevalence of 83% in patients with drug resistant hypertension (high blood pressure which does not respond to three or more medications). While a number of studies have demonstrated statistically significant but modest improvement in blood pressure with CPAP therapy, the 2014 meta-analysis published in the Journal of Hypertension showed that for this difficult to treat population, the beneficial changes in systolic and diastolic blood pressure were considerably greater. Specifically, the study found a mean reduction of 7.21 mmHg in ambulatory systolic blood pressure (SBP), and 4.99mmHg in ambulatory diastolic blood pressure (DBP) from baseline after using CPAP therapy. While further research is needed to corroborate these findings, the study's principal investigator, Dr. Ulysses Magalang, hypothesizes that "untreated sleep apnea may be why these people haven’t seen improvement in their blood pressure despite the concurrent use of three or four medications”. Furthermore, the authors believe that "the longer the CPAP is used during the night, the greater the impact,” stressing the need for increased monitoring and support to improve treatment compliance. These changes could translate into a significant reduction in the risk of heart attack and stroke, and possibly a reduction in the medication burden, according to the study's authors, who urge more aggressive screening for sleep apnea in this population.
Sources
Iftikhar, Imran H., et al. "Effect of oral appliances on blood pressure in obstructive sleep apnea: a systematic review and meta-analysis." Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 9.2 (2013): 165.
Sleep Review Magazine, April 6, 2015. "In Resistant Hypertension, Sleep Apnea Treatment Results in Greater Blood Pressure Reduction"