Effects of CPAP on Blood Pressure and Sympathetic Activity in Patients With Diabetes Mellitus, Chronic Kidney Disease, and Resistant Hypertension
Marcel Ruzicka, Greg Knoll, Frans H. H. Leenen, Judith A. Leech, Shawn D. Aaron, Swapnil Hiremath
Abstract
Background: Patients with obstructive sleep apnea (OSA) have increased sympathetic activity and frequently also have resistant hypertension (HTN). Treatment of OSA with continuous positive airway pressure (CPAP) decreases awake and sleep blood pressure (BP) and sympathetic activity. This study was designed to assess the effect of treatment of OSA with CPAP on sympathetic activity and BP in patients with diabetes mellitus (DM), chronic kidney disease (CKD), and resistant HTN. Methods: This was a randomized, double-blind, sham-controlled trial. Patients with DM, CKD, and resistant HTN were randomized to treatment with a therapeutic or subtherapeutic CPAP for 6 weeks. They underwent 24-hour ambulatory BP monitoring and assessment of muscle sympathetic nerve activity before and after 6 weeks on treatment. R ESUM E Contexte : Les patients atteints d'apn ee obstructive du sommeil (AOS) pr esentent une activit e sympathique accrue qui est souvent accompagn ee d'hypertension art erielle (HTA) r efractaire. Le traitement de l'AOS par ventilation en pression positive continue (CPAP, pour Continuous Positive Airway Pressure) diminue la pression art erielle (PA) l' etat de veille et durant le sommeil ainsi que l'activit e sympathique. Cette etude etait conue pour evaluer l'effet du traitement de l'AOS par CPAP sur l'activit e sympathique et la PA chez des patients atteints de diabte sucr e (DS), d'insuffisance r enale chronique (IRC) et d'HTA r efractaire. M ethodologie : Il s'agissait d'une etude double insu et r epartition al eatoire contrl ee par simulation. Les patients atteints de DS, d'IRC et CJC Open 2 (2020) 258e264