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Göteborgs universitets publikationer

Blood Pressure Response to Losartan and CPAP in Hypertension and Obstructive Sleep Apnea

Författare och institution:
Erik Thunström (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); Karin Manhem (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); Annika Rosengren (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); Yüksel Peker (Institutionen för medicin, avdelningen för molekylär och klinisk medicin)
Publicerad i:
American journal of respiratory and critical care medicine, 193 ( 3 ) s. 310-320
1535-4970 (Electronic) 1073-449X (Linking)
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
RATIONALE: Obstructive sleep apnea (OSA) is common in people with hypertension, particularly resistant hypertension. Treatment with an antihypertensive agent alone is often insufficient to control hypertension in patients with OSA. OBJECTIVES: To determine whether CPAP added to treatment with an antihypertensive agent has an impact on blood pressure (BP) levels. METHODS: During the initial 6-week, 2-center, open, prospective, case-control, parallel-design study (2:1; OSA/no-OSA), all patients began treatment with an angiotensin II receptor antagonist, losartan, 50 mg daily. In the second 6-week, sex-stratified, open, randomized, parallel-design study of the OSA group, all subjects continued to receive losartan and were randomly assigned to either nightly CPAP as add-on therapy or no CPAP. MEASUREMENTS: Twenty-four hour BP monitoring included every-15-minute assessment during daytime hours and every 20 minutes during the night. MAIN RESULTS: Ninety-one patients with untreated hypertension underwent a home sleep study (55 were found to have OSA; 36 were not). Losartan significantly reduced systolic, diastolic, and mean arterial BP in both groups (without OSA: 12.6, 7.2, and 9.0 mmHg; with OSA: 9.8, 5.7, and 6.1 mmHg). Add-on CPAP treatment did not change 24-h BP values significantly, but did reduce nighttime systolic BP by 4.7 mmHg. All 24-hour BP values were reduced significantly in the 13 patients with OSA who used CPAP at least 4 hours per night. CONCLUSIONS: Losartan reduced BP in OSA, but the reductions were less than in no-OSA. Add-on CPAP therapy resulted in no significant changes in 24-h BP measures except in patients using CPAP efficiently. Clinical trial registration available at, ID NCT00701428.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
Allmän medicin
Postens nummer:
Posten skapad:
2015-12-14 15:06
Posten ändrad:
2016-03-22 11:53

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