Effects of CPAP on “vascular” risk factors in patients with obstructive sleep apnea and arterial hypertension

Figures & data

Figure 1 Study design.

Note: Of the remaining 44 patients, two subjects refused pCPAP because of complaints of “shortness of breath” and fail to fall asleep, This was taken into account in the statistical analysis.
Abbreviations: ABPM, ambulatory blood pressure monitoring; BP, blood pressure; val, valsartan; aml, amlodipine; HCT, hydrochlorothiazide; CPAP, continuous positive airways pressure; eCPAP, effective CPAP; pCPAP, placebo CPAP; OSA, obstructive sleep apnea.

Table 1 Main characteristics of the population

Gender (M/F)	34/10
Age (years)	55.5 ± 9.6
Body mass index (kg/m^2)	37.7 ± 7.8
Apnea-hypopnea index (obstructive events per hour)	63.4 ± 26.3
Mean duration of arterial hypertension (years)	15.7 ± 7.3
Previous antihypertensive treatment (n)	27
Mean blood pressure (mmHg)	119.9 ± 11.3
Smoking status: current/former (n/%)	3 (10)
Glucose abnormalities (n/%)	29 (66)
Very high and high risk according to ESH guideline (n, %)	31 (73)
SCORE (%)	9.4 ± 5.1

Note: Mean ± standard deviation.

Abbreviations: ESH, European Society of Hypertension; SCORE, Systemic Coronary Risk Evaluation.

Table 2 Blood pressure values according to treatment regimen

Mean ± SD	Baseline	AT	pCPAP	eCPAP
Office systolic BP (mmHg)	166 ± 11	141 ± 11*	140 ± 9	135 ± 10#
Office diastolic BP (mmHg)	96 ± 11	85 ± 8*	86 ± 9	80 ± 8#
Central systolic BP (mmHg)	155 ± 11	129 ± 11*	126 ± 8	122 ± 10#
Central diastolic BP (mmHg)	97 ± 13	86 ± 10*	85 ± 10	81 ± 9#
PWV (m/sec)	13.9 ± 2.8	12.0 ± 2.5*	12.0 ± 2.7	11.3 ± 2.7*,#
AASI	0.55 ± 0.17	0.48 ± 0.39	0.54 ± 0.28	0.41 ± 0.18*
AIx75**	25.6 ± 11.1	21.6 ± 12.0	21.7 ± 15.1	19.7 ± 14.3*

Notes:

* P < 0.05 versus baseline;

# P < 0.05 versus antihypertensive therapy;

** AIx values were normalized to a standard heart rate of 75 per minutes.

Abbreviations: AASI, ambulatory arterial stiffness index; AIx, augmentation index; AT, antihypertensive therapy; BP, blood pressure; CPAP, continuous positive airways pressure; eCPAP, effective CPAP; SD, standard deviation; pCPAP, placebo CPAP; PWV, pulse wave velocity.

Figure 2 Pulse wave velocity recordings (normal < 12 m/sec).

Note: *P < 0.05 vs AT.
Abbreviations: AT, antihypertensive therapy; CPAP, continuous positive airways pressure; eCPAP, effective CPAP; pCPAP, placebo CPAP; PWV, pulse wave velocity.

Figure 3 Changes in carotid-femoral PWV and AASI after antihypertensive therapy and CPAP therapy.

Notes: *P > 1.05 vs baseline; ^#P > 1.05 vs AHT.
Abbreviations: AHT, antihypertensive therapy; eCPAP, effective continuous positive airways pressure; cfPWV, carotid-femoral pulse wave velocity; AASI, ambulatory arterial stiffness index.