• Zhonghua yi xue za zhi · Jul 2009

    [Efficacy of continuous positive airway pressure therapy upon resistant hypertension in patients with obstructive sleep apnea hypopnea syndrome].

    • Xi-Long Zhang and Yan-Qun Li.
    • Department of Respiratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. zhangxilong1952@yahoo.com.cn
    • Zhonghua Yi Xue Za Zhi. 2009 Jul 14; 89 (26): 1811-4.

    ObjectiveTo investigate the efficacy and possible mechanism of continuous positive airway pressure (CPAP) therapy upon blood pressure in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and resistant hypertension (RH).MethodsThirteen OSAHS patients with RH were recruited. Before and after 3-month CPAP therapy, their blood pressures at 10:00 PM, 2:00 AM and 6:00 AM were measured and their morning plasma concentrations of aldosterone (ALD) and plasma renin activity (PRA) tested at supine position with radioimmunoassay.ResultsCompared with blood pressure parameters at pre-CPAP therapy, there was a significant decrease in blood pressure before sleep at the end of 3-month CPAP therapy [(135.5 +/- 2.8)/(84.2 +/- 4.6) vs (152.2 +/- 19.2)/(98.9 +/- 15.6) mm Hg, P < 0.01], at night during sleep [ (133.1 +/- 2.4)/(81.5 +/- 4.6) vs (156.6 +/- 19.4)/(102.8 +/- 16.6) mm Hg, P < 0.01] and in the early morning [(151.5 +/- 3.0)/(81.2 +/- 3.2) vs (172.1 +/- 23.7)/(98.1 +/- 6.5) mm Hg, P < 0.01]. Comparison of plasma concentrations of ALD and PRA before and after 3-month CPAP therapy indicated that there was a significant difference in ALD [(538 +/- 42) vs (408 +/- 53) pmol/L, P < 0.01] but not significantly different in PRA [(0.27 +/- 0.14) microg x L(-1) x h(-1) vs (0.20 +/- 0.12), P = 0.221].ConclusionsCPAP therapy could significantly improve RH and plasma ALD concentration. Elevated plasma ALD concentration is possibly involved in the pathogenesis of RH in OSAHS patients.

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