Continuous positive airway pressure treatment on blood pressure rhythm in hypertension patients with obstructive sleep apnea / 中华老年医学杂志

ABSTRACT

Objective:To investigate the effect of continuous positive airway pressure(CPAP)on blood pressure and blood pressure rhythm in hypertensive patients with sleep apnea syndrome.Methods:Hypertensive patients with obstructive sleep apnea syndrome consecutively recruited between 2020 and 2022 were randomly divided into two groups, the CPAP group and the control group.Both groups were routinely treated with antihypertensive drugs, and patients in the CPAP group were additionally treated with CPAP for more than 4 hours at night.24-hour ambulatory blood pressure monitoring was conducted following 12 weeks of treatment, and the blood pressure rhythm was analyzed according to blood pressure results.Results:A total of 104 patients(40-73 years old)were enrolled in the study, with 51 patients(mean age 57.3±9.1)in the CPAP group(58.8% male)and 53 patients(mean age 58.3±8.1)in the control group(54.7% male). The results of 24-hour ambulatory blood pressure monitoring showed that, compared with the control group, the CPAP group achieved more effective blood pressure reduction in mean systolic blood pressure(SBP)[(134.6±8.4)mmHg vs.(138.2±5.9)mmHg, t=-2.54, P=0.013], mean DBP[(72.4±9.3)mmHg vs.(77.0±9.0), t=-2.56, P=0.012], mean nighttime SBP[(117.2±5.1)mmHg vs.(122.0±6.2)mmHg, t=-4.283, P<0.01]and mean nighttime DBP[(63.7±6.4)mmHg vs.(66.9±5.1)mmHg, t=-2.812, P<0.01). There was a significant increase in blood pressure dippers in the CPAP group(37.25% vs.18.87%, χ2=4.370, P=0.037). Conclusions:CPAP can significantly reduce 24-hour mean blood pressure and nocturnal blood pressure, and improve blood pressure rhythm in hypertensive patients with sleep apnea syndrome.