No significant effect of CPAP on cardio events, HTN; however, CPAP linked to reduced HTN in second study
TUESDAY, May 22 (HealthDay News) -- For patients with obstructive sleep apnea (OSA) without daytime sleepiness, continuous positive airway pressure (CPAP) does not significantly affect the incidence of hypertension or cardiovascular events; however, regular use of CPAP may reduce the increased risk of incident hypertension seen among patients with OSA, according to two studies published in the May 23/30 issue of the Journal of the American Medical Association.
Ferran Barbé, M.D., from the Coordinator Center in Lleida, Spain, and colleagues conducted a randomized controlled trial to assess the effect of CPAP treatment on the incidence of hypertension or cardiovascular events in a cohort of 723 nonsleepy patients with OSA. During a median of four years of follow-up, the researchers observed no significant difference between the groups, with hypertension and cardiovascular event density rates of 9.2 and 11.02 per 100 person-years in the CPAP and control groups, respectively (incidence density ratio, 0.83; P = 0.20).
In a second study, José M. Marin, M.D., from the Hospital Universitario Miguel Servet in Zaragoza, Spain, and colleagues conducted a prospective cohort study of 1,889 participants without hypertension who were referred to a sleep center. During a median of 12.2 years of follow-up, the researchers found that, compared with controls, there was a significantly increased risk of incident hypertension among patients with OSA who were ineligible for, declined, or were nonadherent to CPAP therapy (adjusted hazard ratios [HR], 1.33, 1.96, and 1.78, respectively). The risk of hypertension was lower for patients with OSA who were treated with CPAP (HR, 0.71).
"Although these studies significantly advance the understanding of the positive relationship between OSA and incident hypertension and the benefit of CPAP therapy, many questions remain regarding OSA, hypertension, and treatment," write the authors of an accompanying editorial.
One editorial author disclosed financial ties to the pharmaceutical industry.
Abstract - Barbé
Abstract - Marin