(Hypertension. 2000;35:144.)
© 2000 American Heart Association, Inc.
Scientific Contributions |
Effect of Continuous Positive Airway Pressure on Blood Pressure
A Placebo Trial
From the Departments of Psychiatry (J.E.D.) and Medicine (J.S.L.), University of California at San Diego, and San Diego State University/University of California at San Diego Joint Doctoral Program in Clinical Psychology (J.P.).
Correspondence to Dr Joel E. Dimsdale, University of California at San Diego, La Jolla, CA 92093-0804. E-mail jdimsdale{at}ucsd.edu
Abstract—This study examined the effect of continuous positive airway pressure (CPAP) treatment on blood pressure in patients with obstructive sleep apnea. Thirty-nine patients with sleep apnea were studied. Ambulatory blood pressure monitoring was obtained before and after patients were randomized to receive either 1 week of CPAP or placebo CPAP (CPAP administered at ineffective pressure). Blood pressure was examined over daytime hours (6 AM to 10 PM) and during nighttime hours (10 PM to 6 AM). Daytime mean arterial blood pressure decreased significantly but equally in both the active treatment group and the placebo treatment group (P=0.001). Nighttime mean arterial pressure levels decreased to a much greater extent over time in the patients who received active CPAP treatment (P=0.032). CPAP does appear to decrease nighttime blood pressure. However, the decrease in daytime blood pressure may reflect a nonspecific response (ie, placebo), since both the active treatment group and the placebo treatment group developed comparable decreases in blood pressure.
Key Words: apnea • blood pressure • blood pressure monitoring, ambulatory • placebo effect
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|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
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|
|
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|
|
|
|
|
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|
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|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 C. Zoccali, F. Mallamaci, and G. Tripepi Sleep Apnea in Renal Patients J. Am. Soc. Nephrol., December 1, 2001; 12(12): 2854 - 2859. [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
O. Parra Sleep-disordered breathing and stroke: is there a rationale for treatment? Eur. Respir. J., October 1, 2001; 18(4): 619 - 622. [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
J. F. FACCENDA, T. W. MACKAY, N. A. BOON, and N. J. DOUGLAS Randomized Placebo-controlled Trial of Continuous Positive Airway Pressure on Blood Pressure in the Sleep Apnea-Hypopnea Syndrome Am. J. Respir. Crit. Care Med., February 1, 2001; 163(2): 344 - 348. [Abstract] [Full Text]
|
|