LONG-TERM EFFECT OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY (CPAP) IN HYPERTENSIVE PATIENTS WITH SLEEP APNEA AND METABOLIC IMPAIRMENT

Objective: Obstructive sleep apnea (OSA) is associated with the high prevalence of cardiovascular diseases, and such disease manifestations as obesity, arterial hypertension (AH), violation of carbohydrate metabolism, dyslipidemia and endothelial dysfunction. However, the effects of Continuous Posit...

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Main Authors: M. V. Gorbunova, S. L. Babak, A. G. Maliavin
Format: Article
Language:Russian
Published: SINAPS LLC 2017-09-01
Series:Архивъ внутренней медицины
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Online Access:https://www.medarhive.ru/jour/article/view/699
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author M. V. Gorbunova
S. L. Babak
A. G. Maliavin
author_facet M. V. Gorbunova
S. L. Babak
A. G. Maliavin
author_sort M. V. Gorbunova
collection DOAJ
description Objective: Obstructive sleep apnea (OSA) is associated with the high prevalence of cardiovascular diseases, and such disease manifestations as obesity, arterial hypertension (AH), violation of carbohydrate metabolism, dyslipidemia and endothelial dysfunction. However, the effects of Continuous Positive Airway Pressure therapy (Continuous Positive Airway Pressure — CPAP therapy) on the normalization of blood pressure in patients with OAS+AH are poorly understood and poorly studied. The aim of the study was to investigate 12-month effects of long-term CPAP-therapy with auto-adaptation to inhalation and exhalation (A-Flex therapy) on blood pressure in patients with OSA+AH. Methods: To the prospective single-center study were included 177 patients with snoring, metabolic disorders, obstructive sleep apnea, and hypertension with the established drug therapy (138 men [78%] and 37 females [21%]), in age interval of 35-75 years (56,4 ± 9,4) which apnea-hypopnea index (AHI) > 5 event/hour. The night polygraphy study (PG) was performed to calculate AHI, oxygen desaturation index (ODI), mean nocturnal saturation (Sp02 mean) by the rules of American Academy of Sleep Medicine (AASM). Optimal level of A-Flex therapy was adjusted at home. AHI, the level of air leakage, average pressure and compliance to CPAP treatment were established in accordance with international requirements. Results: After 12 months of A-Flex therapy we found a significant decrease of level of systolic and diastolic blood pressure. The group of CPAP-therapy has decreased daytime SBP on -5.9 mmHg (95% Cl from -3.2 to -7.1; P=0.02) and night SBP on -4.1 mmHg (95% Cl from -6.1 to -2.6; P=0.01). Similar dynamics was observed in variations of DBP. The group of CPAP-therapy decreased daytime DBP on -1.1 mm Hg (95% Cl from -2.2 to -0.5; P=0.02) and nighttime DBP on -5.1 mm Hg (95% Cl from -7.2 to -3.5; P=0.01). In addition, the group of CPAP-therapy have clinical changing of excessive daytime sleepiness, expanding physical activity, normalization of night sleep. Conclusions: The 12-month A-Flex therapy in OSA patients with AH has a significant therapeutic effect of stabilization systolic and diastolic blood pressure. The long-term 12-month A-Flex therapy has to reduce the risks of cardiovascular events in moderate and severe OSA patients with acute metabolic manifestations and arterial hypertension.
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spelling doaj-art-b848fb901dcb4ffda32fa91b8f4a23cc2025-08-20T03:37:57ZrusSINAPS LLCАрхивъ внутренней медицины2226-67042411-65642017-09-017537137710.20514/2226-6704-2017-7-5-371-377634LONG-TERM EFFECT OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY (CPAP) IN HYPERTENSIVE PATIENTS WITH SLEEP APNEA AND METABOLIC IMPAIRMENTM. V. Gorbunova0S. L. Babak1A. G. Maliavin2Moscow State University of Medicine and Dentistry named after A.I. EvdokimovMoscow State University of Medicine and Dentistry named after A.I. EvdokimovMoscow State University of Medicine and Dentistry named after A.I. EvdokimovObjective: Obstructive sleep apnea (OSA) is associated with the high prevalence of cardiovascular diseases, and such disease manifestations as obesity, arterial hypertension (AH), violation of carbohydrate metabolism, dyslipidemia and endothelial dysfunction. However, the effects of Continuous Positive Airway Pressure therapy (Continuous Positive Airway Pressure — CPAP therapy) on the normalization of blood pressure in patients with OAS+AH are poorly understood and poorly studied. The aim of the study was to investigate 12-month effects of long-term CPAP-therapy with auto-adaptation to inhalation and exhalation (A-Flex therapy) on blood pressure in patients with OSA+AH. Methods: To the prospective single-center study were included 177 patients with snoring, metabolic disorders, obstructive sleep apnea, and hypertension with the established drug therapy (138 men [78%] and 37 females [21%]), in age interval of 35-75 years (56,4 ± 9,4) which apnea-hypopnea index (AHI) > 5 event/hour. The night polygraphy study (PG) was performed to calculate AHI, oxygen desaturation index (ODI), mean nocturnal saturation (Sp02 mean) by the rules of American Academy of Sleep Medicine (AASM). Optimal level of A-Flex therapy was adjusted at home. AHI, the level of air leakage, average pressure and compliance to CPAP treatment were established in accordance with international requirements. Results: After 12 months of A-Flex therapy we found a significant decrease of level of systolic and diastolic blood pressure. The group of CPAP-therapy has decreased daytime SBP on -5.9 mmHg (95% Cl from -3.2 to -7.1; P=0.02) and night SBP on -4.1 mmHg (95% Cl from -6.1 to -2.6; P=0.01). Similar dynamics was observed in variations of DBP. The group of CPAP-therapy decreased daytime DBP on -1.1 mm Hg (95% Cl from -2.2 to -0.5; P=0.02) and nighttime DBP on -5.1 mm Hg (95% Cl from -7.2 to -3.5; P=0.01). In addition, the group of CPAP-therapy have clinical changing of excessive daytime sleepiness, expanding physical activity, normalization of night sleep. Conclusions: The 12-month A-Flex therapy in OSA patients with AH has a significant therapeutic effect of stabilization systolic and diastolic blood pressure. The long-term 12-month A-Flex therapy has to reduce the risks of cardiovascular events in moderate and severe OSA patients with acute metabolic manifestations and arterial hypertension.https://www.medarhive.ru/jour/article/view/699obstructive sleep apneametabolic syndromecardiovascular diseasearterial hypertensionlong-term cpap therapya-flex therapy
spellingShingle M. V. Gorbunova
S. L. Babak
A. G. Maliavin
LONG-TERM EFFECT OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY (CPAP) IN HYPERTENSIVE PATIENTS WITH SLEEP APNEA AND METABOLIC IMPAIRMENT
Архивъ внутренней медицины
obstructive sleep apnea
metabolic syndrome
cardiovascular disease
arterial hypertension
long-term cpap therapy
a-flex therapy
title LONG-TERM EFFECT OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY (CPAP) IN HYPERTENSIVE PATIENTS WITH SLEEP APNEA AND METABOLIC IMPAIRMENT
title_full LONG-TERM EFFECT OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY (CPAP) IN HYPERTENSIVE PATIENTS WITH SLEEP APNEA AND METABOLIC IMPAIRMENT
title_fullStr LONG-TERM EFFECT OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY (CPAP) IN HYPERTENSIVE PATIENTS WITH SLEEP APNEA AND METABOLIC IMPAIRMENT
title_full_unstemmed LONG-TERM EFFECT OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY (CPAP) IN HYPERTENSIVE PATIENTS WITH SLEEP APNEA AND METABOLIC IMPAIRMENT
title_short LONG-TERM EFFECT OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY (CPAP) IN HYPERTENSIVE PATIENTS WITH SLEEP APNEA AND METABOLIC IMPAIRMENT
title_sort long term effect of continuous positive airway pressure therapy cpap in hypertensive patients with sleep apnea and metabolic impairment
topic obstructive sleep apnea
metabolic syndrome
cardiovascular disease
arterial hypertension
long-term cpap therapy
a-flex therapy
url https://www.medarhive.ru/jour/article/view/699
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AT slbabak longtermeffectofcontinuouspositiveairwaypressuretherapycpapinhypertensivepatientswithsleepapneaandmetabolicimpairment
AT agmaliavin longtermeffectofcontinuouspositiveairwaypressuretherapycpapinhypertensivepatientswithsleepapneaandmetabolicimpairment