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Somers - Figure 33

The HIPARCO Randomized Clinical Trial

FIG. 33:  The question must be, what happens if patients with sleep apnea and resistant hypertension are treated with CPAP therapy?  The Figure summarizes the results of another randomized control trial that looked at CPAP versus usual care for a period of 3 months in almost 200 patients who had a combination of resistant hypertension and moderate-to-severe OSA (AHI >15).[19]  The data were analyzed on an intention-to-treat basis and found that CPAP reduced mean, diastolic, and systolic blood pressure by about 3 mmHg.  The fall in systolic pressure was did not reach significance whereas both mean and diastolic pressures fell significantly. 

Thus the message here, again, is that even in resistant hypertension patients with fairly significant sleep apnea, CPAP is able to reduce blood pressure by only about 3 mmHg. 

Somers V. Chest 2016:00.

References

[19]

Martinez-García MA, Capote F, Campos-Rodríguez F, et al. Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: the HIPARCO randomized clinical trial. 2013;310:2407–2415.