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Blood Pressure Variability in Obstructive Sleep Apnoea: Data from 4 Randomised Controlled CPAP Withdrawal Trials
Franziska Lettau1, Esther I Schwarz, John R Stradling
1Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Respiration; International Review of Thoracic Diseases
|March 29, 2017
Summary
Discontinuing continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA) slightly increases office systolic blood pressure variability. However, it does not significantly impact home blood pressure variability, suggesting OSA may not elevate cardiovascular risk through this mechanism.
Area of Science:
- Cardiology
- Sleep Medicine
- Hypertension Research
Background:
- Increased daytime blood pressure variability (BPV) is a known cardiovascular risk factor.
- Preliminary evidence suggests a potential link between obstructive sleep apnea (OSA) and elevated daytime BPV.
Purpose of the Study:
- To investigate the impact of withdrawing continuous positive airway pressure (CPAP) therapy on patients with OSA.
- To assess the effect of CPAP cessation on various measures of daytime blood pressure variability.
Main Methods:
- 183 patients with OSA on CPAP were randomized to continue or withdraw from therapy.
- Office morning blood pressure (BP) was measured in triplicate at baseline and day 14.
- Participants also performed daily home BP measurements for 13 days.
Main Results:
- CPAP withdrawal led to a significant increase in within-visit systolic BPV in office settings (SD difference +1.14 mm Hg, p=0.02).
- No significant changes were observed in within-visit diastolic BPV or heart rate variability.
- Home-based morning and day-to-day BPV measures did not differ significantly between groups.
Conclusions:
- CPAP withdrawal causes a small increase in office systolic BPV but does not affect home BPV.
- The findings suggest that OSA may not significantly contribute to cardiovascular risk through elevated daytime BPV.
- The potential blunting effect of antihypertensive medications on observed treatment effects was noted.
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