When is CPAP indicated in the treatment of resistant hypertension (high blood pressure)?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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However, treatment with CPAP may reduce BP in patients with resistant hypertension and sleep apnea. In the Spanish open-label, randomized HIPARCO trial, 98 patients with obstructive sleep apnea (OSA) and resistant hypertension who were treated with 12 weeks of continuous positive airway pressure (CPAP) had significantly improved 24-hour mean and diastolic blood pressure (BP) measurements, as compared to BP in 96 patients who did not receive CPAP therapy. [121, 122]  Reductions in 24-hour mean and diastolic BP in the CPAP group were 3.1 mm Hg and 3.2 mm Hg, respectively, but there was no change in 24-hour systolic BP. However, a per-protocol analysis showed reductions in 24-hour mean BP (4.4 mm Hg) and diastolic BP (4.1 mm Hg) and a significant decrease in 24-hour systolic BP (4.9 mm Hg). [121, 122]

In addition, 35.9% of those on CPAP therapy showed improvements in their nocturnal BP pattern (ie, ≥10% decrease in average nighttime vs average daytime BP), as compared to 21.6% in the control group. There was also a significant correlation between duration of CPAP use and the reduction in BP levels. [121, 122]


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