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Título: | The HIPARCO-2 study: long-term effect of continuous positive airway pressure on blood pressure in patients with resistant hypertension: a multicenter prospective study |
Autor: | Navarro-Soriano, Cristina; Torres, Gerard; Barbé, Ferrán; Sánchez de la Torre, Manuel; Mañas Escorza, Pedro CSIC; Lloberes, Patricia; Díaz-Cambriles, Trinidad; Somoza, María; Masa, Juan F.; González, Mónica CSIC; Mañas, Eva; Peña, Mónica de la; García-Río, Francisco; Montserrat, Josep M. CSIC ORCID; Muriel, Alfonso; Oscullo, Grace; García-Ortega, Alberto; Posadas, Tomás; Campos-Rodríguez, Francisco CSIC ORCID; Martínez-García, Miguel Ángel | Fecha de publicación: | feb-2021 | Editor: | Lippincott Williams & Wilkins | Citación: | Journal of Hypertension 39(2): 302-309 (2021) | Resumen: | [Introduction] Short-term treatment with continuous positive airway pressure (CPAP) produces a clinically significant reduction in blood pressure (BP) in patients with obstructive sleep apnea (OSA) and resistant hypertension. However, it is unknown whether this effect continues over the long-term. Our objective was to assess the effect of long-term CPAP on BP in patients with OSA and resistant hypertension. [Methods] The study included 161 patients diagnosed with both OSA [apnea--hypopnea index (AHI) ≥15] and resistant hypertension diagnosed via 24-hour ambulatory BP measurement (24-h ABPM), in whom a second analysis via 24-h ABPM was performed at the end of the follow-up. [Results] Patients were followed up within 59 months [interquartile range (IQR): 44–70]. CPAP treatment was prescribed to 82% of the patients (70% with good adherence to CPAP defined as use of CPAP at least 4 h/night). A comparison between the adherent group and nonadherent group (including those with CPAP not prescribed) showed that CPAP adherents had a significant drop in the 24-h BP, both systolic [−3.9 mmHg; 95% confidence interval (CI): −8.1 to 0.3] and diastolic pressure (−3.5 mmHg [95% [CI]: −6.4–0.5]), with a higher magnitude during the night (−5.5 and −4.9 mmHg, respectively). The CPAP adherent group needed a mean of 1.1 less antihypertensive drugs (particularly spironolactone). Finally, there was a positive correlation between the drop in 24-h SBP and the hours of CPAP use (r = 0.24; P = 0.01). [Conclusion] Good adherence to long-term CPAP treatment largely succeeded in significantly reducing BP in those patients with OSA and resistant hypertension, despite the use of a lower number of antihypertensive drugs. |
Descripción: | Spanish Sleep Network. | Versión del editor: | http://doi.org/10.1097/HJH.0000000000002664 | URI: | http://hdl.handle.net/10261/239897 | DOI: | 10.1097/HJH.0000000000002664 | Identificadores: | doi: 10.1097/HJH.0000000000002664 e-issn: 1473-5598 issn: 0263-6352 |
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