Blood Pressure Changes After Automatic and Fixed CPAP in Obstructive Sleep Apnea: Relationship with Nocturnal Sympathetic Activity.
Summary of "Blood Pressure Changes After Automatic and Fixed CPAP in Obstructive Sleep Apnea: Relationship with Nocturnal Sympathetic Activity."
Treatment of obstructive sleep apnea (OSA) by continuous positive airway pressure (CPAP) usually causes a reduction in blood pressure (BP), but several factors may interfere with its effects. In addition, although a high sympathetic activity is considered a major contributor to increased BP in OSA, a relationship between changes in BP and in sympathetic nervous system activity after OSA treatment is uncertain. This study was undertaken to assess if, in OSA subjects under no pharmacologic treatment, treatment by CPAP applied at variable levels by an automatic device (APAP) may be followed by a BP reduction, and if that treatment is associated with parallel changes in BP and catecholamine excretion during the sleep hours. Nine subjects underwent 24-h ambulatory BP monitoring and nocturnal urinary catecholamine determinations before OSA treatment and 2 months following OSA treatment by APAP (Somnosmart2, Weinmann, Hamburg, Germany). Eight control subjects were treated by CPAP at a fixed level. After APAP treatment, systolic blood pressure (SBP) decreased during sleep (p < 0.05), while diastolic blood pressure (DBP) decreased both during wakefulness (p < 0.05) and sleep (p < 0.02). Similar changes were observed in subjects receiving fixed CPAP. Nocturnal DBP changes were correlated with norepinephrine (in the whole sample: r = .61, p < 0.02) and normetanephrine (r = .71, p < 0.01) changes. In OSA subjects under no pharmacologic treatment, APAP reduces BP during wakefulness and sleep, similarly to CPAP. A reduction in nocturnal sympathetic activity could contribute to the reduction in DBP during sleep following OSA treatment.
Affiliation
Institute of Biomedicine and Molecular Immunology, National Research Council, Palermo, Italy.
Journal Details
This article was published in the following journal.
Name: Clinical and experimental hypertension (New York, N.Y. : 1993)
ISSN: 1525-6006
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21529314
- DOI: http://dx.doi.org/10.3109/10641963.2010.531853
Medical and Biotech [MESH] Definitions
Blood Pressure Monitoring, Ambulatory
Method in which repeated blood pressure readings are made while the patient undergoes normal daily activities. It allows quantitative analysis of the high blood pressure load over time, can help distinguish between types of HYPERTENSION, and can assess the effectiveness of antihypertensive therapy.
Hypertension
Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.
Baroreflex
A response by the BARORECEPTORS to increased BLOOD PRESSURE. Increased pressure stretches BLOOD VESSELS which activates the baroreceptors in the vessel walls. The net response of the CENTRAL NERVOUS SYSTEM is a reduction of central sympathetic outflow. This reduces blood pressure both by decreasing peripheral VASCULAR RESISTANCE and by lowering CARDIAC OUTPUT. Because the baroreceptors are tonically active, the baroreflex can compensate rapidly for both increases and decreases in blood pressure.
Venous Pressure
The blood pressure in the VEINS. It is usually measured to assess the filling PRESSURE to the HEART VENTRICLE.
Blood Pressure
PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.
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