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CPAP Improves BP, Metabolic Abnormalities in Sleep Apnea

Three months of continuous positive airway pressure partially reverses metabolic abnormalities

WEDNESDAY, Dec. 14 (HealthDay News) -- For patients with severe obstructive sleep apnea, three months of continuous positive airway pressure (CPAP) therapy is associated with reduced blood pressure, and partial reversal of metabolic abnormalities, according to a study published in the Dec. 15 issue of the New England Journal of Medicine.

Surendra K. Sharma, M.D., Ph.D., from the All India Institute of Medical Sciences in New Delhi, and colleagues investigated the effects of CPAP treatment on metabolic syndrome in 86 patients with obstructive sleep apnea syndrome. Patients were assigned to real or sham CPAP for three months, followed by a washout period of one month, and then a crossover to the other intervention for three months. Anthropometric variables, blood pressure, fasting blood glucose levels and lipid profile, insulin resistance, glycated hemoglobin levels, carotid intima-media thickness, and visceral fat were measured before and after each intervention.

The investigators found that 87 percent of the participants had metabolic syndrome. Compared with sham CPAP, therapeutic CPAP was associated with significant decreases in systolic blood pressure, diastolic blood pressure, serum total cholesterol, non-high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and glycated hemoglobin. Metabolic syndrome frequency was reduced with CPAP therapy, with reversal seen in 13 percent of patients versus 1 percent of patients undergoing sham CPAP. One patient receiving CPAP therapy developed accelerated hypertension, two developed intolerance to CPAP, and one patient refused to continue sham CPAP.

"In patients with moderate-to-severe obstructive sleep apnea syndrome, three months of CPAP therapy lowers blood pressure and partially reverses metabolic abnormalities," the authors write.

The study was supported by Pfizer.

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