Beneficial response of blood pressure to short-term continuous positive airway pressure in Chinese patients with obstructive sleep apnea-hypopnea syndrome.

Abstract

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is common in people with hypertension and cardiac rhythm disorder. The objectives of this study were to determine the effect of short-term continuous positive airway pressure (CPAP) on blood pressure (BP) and cardiac rhythm in Chinese patients with moderate to severe OSAHS. Eligible patients in the two hospitals were consecutively enrolled into the prospective study. Ambulatory BP monitoring and Holter monitoring were both performed for 24 h in 214 patients who previously encountered a full night polysomnography. Ambulatory BP was measured again in the follow-up of 59 patients with OSAHS who underwent home CPAP for 30 days, whereas Holter was repeated within 2-3 days after institution of CPAP therapy in 15 patients with OSAHS. Fifty-one patients with OSAHS with hypertension who used CPAP for at least 4 h/night received 30 days of CPAP treatment. Added CPAP on usual antihypertension treatment showed that systolic BP, diastolic BP, and mean arterial BP were significantly reduced at night (5.08, 3.05, and 3.73 mmHg, respectively), in the morning (6.31, 4.83, and 5.32 mmHg, respectively), and during the whole a day (3.09, 2.60, and 2.76 mmHg, respectively). There were no significant changes in daytime BP values but did reduce daytime BP by 2.09, 2.37, and 2.28 mmHg, respectively. In addition, CPAP therapy resulted in abolition of most sinus pauses and atrioventricular block in the 15 patients with OSAHS having coexisting pathologically rhythm disturbances, whereas the effect on other types of arrhythmia was not effective enough. Short-term CPAP reduced BP modestly in patients with OSAHS with hypertension, especially in the morning and at night-time.