{"title":"Impact of adherence and study design on CPAP effectiveness in resistant hypertension.","authors":"Abdullah Sarıhan, Macit Kalçık, Mucahit Yetim","doi":"10.1038/s41371-025-01076-8","DOIUrl":null,"url":null,"abstract":"<p><p>This letter comments on the recent article by Fernandes et al. evaluating the long-term effects of continuous positive airway pressure (CPAP) in patients with resistant hypertension and obstructive sleep apnea. While the study provides valuable insights into prolonged CPAP use, its non-randomized design and reliance on per-protocol analyses limit the generalizability of the findings. Evidence from previous randomized and multicenter studies suggests that the benefits of CPAP are modest and often diminish over time. Moreover, the exclusive focus on blood pressure outcomes overlooks broader cardiovascular effects, and the role of psychosocial and socioeconomic determinants of adherence remains underexplored. Future large-scale, randomized studies that integrate clinical and behavioral factors are needed to better define the long-term role of CPAP in resistant hypertension management.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Human Hypertension","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41371-025-01076-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
Abstract
This letter comments on the recent article by Fernandes et al. evaluating the long-term effects of continuous positive airway pressure (CPAP) in patients with resistant hypertension and obstructive sleep apnea. While the study provides valuable insights into prolonged CPAP use, its non-randomized design and reliance on per-protocol analyses limit the generalizability of the findings. Evidence from previous randomized and multicenter studies suggests that the benefits of CPAP are modest and often diminish over time. Moreover, the exclusive focus on blood pressure outcomes overlooks broader cardiovascular effects, and the role of psychosocial and socioeconomic determinants of adherence remains underexplored. Future large-scale, randomized studies that integrate clinical and behavioral factors are needed to better define the long-term role of CPAP in resistant hypertension management.
期刊介绍：
Journal of Human Hypertension is published monthly and is of interest to health care professionals who deal with hypertension (specialists, internists, primary care physicians) and public health workers. We believe that our patients benefit from robust scientific data that are based on well conducted clinical trials. We also believe that basic sciences are the foundations on which we build our knowledge of clinical conditions and their management. Towards this end, although we are primarily a clinical based journal, we also welcome suitable basic sciences studies that promote our understanding of human hypertension.
The journal aims to perform the dual role of increasing knowledge in the field of high blood pressure as well as improving the standard of care of patients. The editors will consider for publication all suitable papers dealing directly or indirectly with clinical aspects of hypertension, including but not limited to epidemiology, pathophysiology, therapeutics and basic sciences involving human subjects or tissues. We also consider papers from all specialties such as ophthalmology, cardiology, nephrology, obstetrics and stroke medicine that deal with the various aspects of hypertension and its complications.
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