In the LiteratureResistant Hypertension in Obstructive Sleep Apnea: Is Continuous Positive Airway Pressure the Next Step?
Section snippets
What does this important study show?
A recent publication by Martínez-Garcia et al10 in JAMA explored the effect of CPAP on BP in patients with OSA and resistant hypertension in the HIPARCO (Hipertensión Arterial Resistente Control con CPAP) trial. This randomized controlled trial from the Spanish Sleep Network recruited patients aged 18-75 years with resistant hypertension from the hypertension clinical units of 24 hospitals in Spain. All participants underwent respiratory polygraphy (American Academy of Sleep Medicine type III
How does this study compare with prior studies?
This study offers the most convincing evidence to date showing CPAP to have a beneficial BP-lowering effect in patients with resistant hypertension and OSA. Limited data from prior observational studies15 and prospective trials11, 16, 17, 18 indicate that clinically significant BP reductions can be attained when there is good adherence to CPAP treatment. As mentioned, the only other randomized trial specifically evaluating the effect of CPAP in resistant hypertension was conducted by Pedrosa
What should clinicians and researchers do?
Despite its limitations, results of this large multicenter study have important clinical and research implications, although more research is warranted to assess long-term health outcomes of CPAP use on cardiovascular events and mortality. One of the biggest challenges for this kind of research continues to be patient acceptance of CPAP therapy over longer periods. The present study was remarkable in achieving >70% adherence to at least 4 hours of CPAP use per night. A recent meta-analysis
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