{"title":"持续气道正压和降压药物治疗阻塞性睡眠呼吸暂停相关高血压的比较疗效：一项叙述性综述。","authors":"Olumide Damilola Akinmoju, Gbolahan Olatunji, Emmanuel Kokori, Ikponmwosa Jude Ogieuhi, Adetola Emmanuel Babalola, Emeka Stanley Obi, Chidera Stanley Anthony, Odemona Glory Toluwanibukun, Adewunmi Akingbola, Adedoyin Esther Alao, Adenowo Goodness Boluwatife, Aarushi Venkatraman, Areesha Babar, Nicholas Aderinto","doi":"10.1007/s40292-024-00691-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea (OSA) presents a significant global health concern, affecting a substantial portion of the population, particularly among young and middle-aged adults.</p><p><strong>Aim: </strong>This review aims to assess the efficacy of continuous positive airway pressure (CPAP) compared to antihypertensive medications in managing OSA-related hypertension.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases, yielding studies published from 2000 to March 2024 that investigated CPAP, antihypertensives, or their combination therapy in OSA patients. Six definitive studies were analyzed, including two randomized controlled trials (RCTs), one randomized double-blind placebo-controlled crossover trial, one placebo-controlled trial, one open-label multicenter trial, and one longitudinal cohort study. These studies comprised 939 participants, with intervention durations ranging from four weeks to six months.</p><p><strong>Results: </strong>Analysis of CPAP monotherapy revealed variable efficacy, with some studies demonstrating significant reductions in 24-hour mean blood pressure and diastolic pressure, while others reported non-significant changes. CPAP therapy combined with antihypertensives showed additive effects, particularly in reducing office blood pressure measurements. Antihypertensive medications, such as valsartan, exhibited superior efficacy in reducing blood pressure compared to CPAP alone. Factors influencing therapy effectiveness included CPAP compliance, patient characteristics, and coexisting comorbidities. Patients with good CPAP adherence experienced greater reductions in blood pressure. The duration of exposure to OSA and the type of hypertension also impacted the therapy response.</p><p><strong>Conclusion: </strong>While CPAP and antihypertensive medications offer significant benefits in managing hypertension among OSA patients, challenges such as CPAP intolerance and medication side effects exist. Personalized treatment considering individual patient factors is crucial for optimal management.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative Efficacy of Continuous Positive Airway Pressure and Antihypertensive Medications in Obstructive Sleep Apnea-Related Hypertension: A Narrative Review.\",\"authors\":\"Olumide Damilola Akinmoju, Gbolahan Olatunji, Emmanuel Kokori, Ikponmwosa Jude Ogieuhi, Adetola Emmanuel Babalola, Emeka Stanley Obi, Chidera Stanley Anthony, Odemona Glory Toluwanibukun, Adewunmi Akingbola, Adedoyin Esther Alao, Adenowo Goodness Boluwatife, Aarushi Venkatraman, Areesha Babar, Nicholas Aderinto\",\"doi\":\"10.1007/s40292-024-00691-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Obstructive sleep apnea (OSA) presents a significant global health concern, affecting a substantial portion of the population, particularly among young and middle-aged adults.</p><p><strong>Aim: </strong>This review aims to assess the efficacy of continuous positive airway pressure (CPAP) compared to antihypertensive medications in managing OSA-related hypertension.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases, yielding studies published from 2000 to March 2024 that investigated CPAP, antihypertensives, or their combination therapy in OSA patients. Six definitive studies were analyzed, including two randomized controlled trials (RCTs), one randomized double-blind placebo-controlled crossover trial, one placebo-controlled trial, one open-label multicenter trial, and one longitudinal cohort study. These studies comprised 939 participants, with intervention durations ranging from four weeks to six months.</p><p><strong>Results: </strong>Analysis of CPAP monotherapy revealed variable efficacy, with some studies demonstrating significant reductions in 24-hour mean blood pressure and diastolic pressure, while others reported non-significant changes. CPAP therapy combined with antihypertensives showed additive effects, particularly in reducing office blood pressure measurements. Antihypertensive medications, such as valsartan, exhibited superior efficacy in reducing blood pressure compared to CPAP alone. Factors influencing therapy effectiveness included CPAP compliance, patient characteristics, and coexisting comorbidities. Patients with good CPAP adherence experienced greater reductions in blood pressure. The duration of exposure to OSA and the type of hypertension also impacted the therapy response.</p><p><strong>Conclusion: </strong>While CPAP and antihypertensive medications offer significant benefits in managing hypertension among OSA patients, challenges such as CPAP intolerance and medication side effects exist. Personalized treatment considering individual patient factors is crucial for optimal management.</p>\",\"PeriodicalId\":12890,\"journal\":{\"name\":\"High Blood Pressure & Cardiovascular Prevention\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2024-12-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"High Blood Pressure & Cardiovascular Prevention\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s40292-024-00691-9\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"High Blood Pressure & Cardiovascular Prevention","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40292-024-00691-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Comparative Efficacy of Continuous Positive Airway Pressure and Antihypertensive Medications in Obstructive Sleep Apnea-Related Hypertension: A Narrative Review.
Introduction: Obstructive sleep apnea (OSA) presents a significant global health concern, affecting a substantial portion of the population, particularly among young and middle-aged adults.
Aim: This review aims to assess the efficacy of continuous positive airway pressure (CPAP) compared to antihypertensive medications in managing OSA-related hypertension.
Methods: A comprehensive literature search was conducted across multiple databases, yielding studies published from 2000 to March 2024 that investigated CPAP, antihypertensives, or their combination therapy in OSA patients. Six definitive studies were analyzed, including two randomized controlled trials (RCTs), one randomized double-blind placebo-controlled crossover trial, one placebo-controlled trial, one open-label multicenter trial, and one longitudinal cohort study. These studies comprised 939 participants, with intervention durations ranging from four weeks to six months.
Results: Analysis of CPAP monotherapy revealed variable efficacy, with some studies demonstrating significant reductions in 24-hour mean blood pressure and diastolic pressure, while others reported non-significant changes. CPAP therapy combined with antihypertensives showed additive effects, particularly in reducing office blood pressure measurements. Antihypertensive medications, such as valsartan, exhibited superior efficacy in reducing blood pressure compared to CPAP alone. Factors influencing therapy effectiveness included CPAP compliance, patient characteristics, and coexisting comorbidities. Patients with good CPAP adherence experienced greater reductions in blood pressure. The duration of exposure to OSA and the type of hypertension also impacted the therapy response.
Conclusion: While CPAP and antihypertensive medications offer significant benefits in managing hypertension among OSA patients, challenges such as CPAP intolerance and medication side effects exist. Personalized treatment considering individual patient factors is crucial for optimal management.
期刊介绍：
High Blood Pressure & Cardiovascular Prevention promotes knowledge, update and discussion in the field of hypertension and cardiovascular disease prevention, by providing a regular programme of independent review articles covering key aspects of the management of hypertension and cardiovascular diseases. The journal includes: Invited ''State of the Art'' reviews. Expert commentaries on guidelines, major trials, technical advances.Presentation of new intervention trials design.''Pros and Cons'' or round tables on controversial issues.Statements on guidelines from hypertension and cardiovascular scientific societies.Socio-economic issues.Cost/benefit in prevention of cardiovascular diseases.Monitoring of healthcare systems.News and views from the Italian Society of Hypertension (including abstracts).All manuscripts are subject to peer review by international experts. Letters to the editor are welcomed and will be considered for publication.
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