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The authors examined the clinical effects of continuous positive airway pressure (CPAP) therapy over 24 months of treatment. The study cohort consisted of 918 patients of average age 53.4 years and with an apnea–hypopnea index of 40 at baseline. CPAP adherence was strongly associated with improvements in diastolic blood pressure (P = .03), which decreased by 0.13 mm Hg every month. The authors did not detect a significant association between CPAP use and systolic blood pressure (P = .12) or body weight (P = .59).
These data are important for neurologists to consider when counseling patients on the potential benefits of CPAP.
Obstructive sleep apnea (OSA) is a common cause of hypertension. Previous studies have demonstrated beneficial short-term effects of continuous positive airway pressure (CPAP) therapy on blood pressure. However, long-term antihypertensive effects of CPAP have not been properly verified. This study examined the longitudinal effect of CPAP therapy adherence on blood pressure among OSA patients. All patients diagnosed with OSA and undergoing subsequent CPAP therapy at a Kanagawa-area sleep clinic were clinically followed for 24 months to examine CPAP adherence, as well as longitudinal changes in blood pressure and body weight because it may become a confound factor for changes in blood pressure. The hours of CPAP usage were collected over the course of 30 nights prior to each follow-up visit (1st, 3rd, 6th, 12th, and 24th month). The relationship between CPAP adherence and blood pressure was analyzed using mixed-effect logistic regression models. A total of 918 OSA patients were enrolled in the study. We found a significant reduction in diastolic blood pressure among patients with good CPAP adherence during the 24-month follow-up period (β = - 0.13, p = 0.03), when compared to the group with poor CPAP adherence. No significant association was found between CPAP adherence and weight loss (β = - 0.02, p = 0.59). Long-term, good CPAP therapy adherence was associated with lower diastolic blood pressure without significant weight loss.