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(Hypertension. 2007;50:289.)
© 2007 American Heart Association, Inc.

Editorial Commentaries

Treating Obstructive Sleep Apnea

Is There More to the Story Than 2 Millimeters of Mercury?

John S. Floras; T. Douglas Bradley

From the Department of Medicine (J.S.F., T.D.B.), University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada; Toronto Rehabilitation Institute (T.D.B.), Toronto, Ontario, Canada; and the University of Toronto (J.S.F., T.D.B.), Toronto, Ontario, Canada.

Correspondence to John S. Floras, Suite 1614, 600 University Ave, Toronto, Ontario M5G 1X5, Canada. E-mail john.floras@utoronto.ca

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Obstructive sleep apnea (OSA), a common disorder, increases the 4-year risk of developing hypertension by 3-fold.¹ In an uncontrolled trial, treatment of OSA when present in drug-resistant hypertension by nasal continuous positive airway pressure (CPAP) achieved substantial reductions in both nighttime and daytime blood pressure (BP).² However, in controlled and uncontrolled studies involving small cohorts of patients with OSA with stage 1 hypertension, prehypertension, or normal BP, the short-term use of CPAP had less or no effect on BP. A meta-analysis in the present issue of Hypertension³ attempts to estimate the effect of this intervention on BP.

The authors identified all of the published trials that reported BP as a primary or a secondary end point in which adults with OSA diagnosed by polysomnography were randomly allocated to therapeutic CPAP or not for 2 weeks. These 16 trials involved 818 participants (86.3% men; mean age: 51 years; mean apnea-hypopnea index: 36.2 events per hour) treated for 24 weeks. From the 15 trials that reported systolic and diastolic BP, the authors calculated a significant mean net reduction of 2.46/1.83 mm Hg with CPAP and, from the 7 trials that reported mean arterial BP, a significant net reduction of 2.22 mm Hg. By comparison, in a previous meta-analysis restricted to 12 trials in which the primary variable of interest was 24-hour mean ambulatory BP, the calculated net decrease was still significant at 1.69 mm Hg.⁴ In the present analysis by Bazzano et al,³ the mean net change in systolic BP tended to . . . [Full Text of this Article]

Related Article:

Effect of Nocturnal Nasal Continuous Positive Airway Pressure on Blood Pressure in Obstructive Sleep Apnea

Lydia A. Bazzano, Zia Khan, Kristi Reynolds, and Jiang He
Hypertension 2007 50: 417-423. [Abstract] [Full Text] [PDF]

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