Titre :

Continuous positive airway pressure reduces night-time blood pressure and heart rate in patients with obstructive sleep apnea and resistant hypertension: the rhoosas randomized controlled trial

Auteur(s) :

Joyeux-Faure, Marie [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire [HP2]
Baguet, Jean-Philippe [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Barone-Rochette, Gilles [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Faure, Patrice [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire [HP2]
Sosner, Philippe [Auteur]
Mounier Vehier, Claire [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Levy, Patrick [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire [HP2]
Tamisier, Renaud [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire [HP2]
Pepin, Jean-Louis [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire [HP2]

Titre de la revue :

Frontiers in neurology

Nom court de la revue :

Front. Neurol.

Numéro :

9

Date de publication :

2018-05-08

ISSN :

1664-2295

Mot(s)-clé(s) en anglais :

blood pressure
obstructive sleep apnea
resistant hypertension
leptin
continuous positive airway pressure

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Most patients with resistant hypertension (RH) have obstructive sleep apnea (OSA). We aimed to determine the impact of OSA and continuous positive airway pressure (CPAP) treatment on the leptin profile and blood pressure ...
Lire la suite >Most patients with resistant hypertension (RH) have obstructive sleep apnea (OSA). We aimed to determine the impact of OSA and continuous positive airway pressure (CPAP) treatment on the leptin profile and blood pressure (BP) in patients with RH. After an initial case-control study (RH with and without OSA), we performed a randomized, single blind study in OSA + RH patients receiving either sham CPAP (3 months) followed by active CPAP (6 months) or 6 months of active CPAP. The primary outcome was the comparison of leptin levels between groups of RH patients with or without OSA. Secondary outcomes were the comparison of metabolic parameters, biomarkers of sympathetic activity, and BP indices between the two groups of RH patients with or without OSA. The same outcomes were then evaluated and compared before and after sham and effective CPAP intervention. Sixty-two patients (60 ± 10 years; 77% men) with RH (24-h daytime systolic BP (SBP)/diastolic BP: 145 ± 13/85 ± 10 mmHg, 3.7 antihypertensive drugs) were included. The 37 RH patients exhibiting OSA (60%) were predominantly men (87 vs 64% for non-OSA patients), with a greater prevalence of metabolic syndrome and higher creatininemia. Their leptin concentrations were significantly lower than in non-OSA patients [9 (6; 15) vs 17 (6; 29) ng/mL] but increased after 6 months of CPAP. Three months of effective CPAP significantly decreased night-time SBP by 6.4 mmHg and heart rate (HR) by 6.0 bpm, compared to sham CPAP. The association between OSA and RH corresponds to a specific, predominately male phenotype with a higher burden of metabolic syndrome and higher creatininemia but there was no significant difference between OSA and non-OSA patients regarding BP indices, and the number of antihypertensive drugs used. Active CPAP could be efficient at decreasing night-time BP and HR, but there was no difference between CPAP and sham CPAP groups for all metabolic and SNS markers (NCT00746902 RHOOSAS).Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2019-12-09T18:18:16Z
2020-04-07T09:50:15Z