Effect of Continuous Positive Airway Pressure for Treatment of Obstructive Sleep Apnea on Resistant Hypertension

The University of Hong Kong (HKU)

Status

Completed

Conditions

Resistant Hypertension

Obstructive Sleep Apnea

Treatments

Device: continuous positive airway pressure

Study type

Interventional

Funder types

Other

Identifiers

NCT00881985

UW 09-051

Details and patient eligibility

About

The objectives of this study are to investigate the effect of continuous positive airway pressure (CPAP) treatment on blood pressure control and vascular inflammation in subjects with resistant hypertension and moderate obstructive sleep apnea (OSA).

Full description

Resistant hypertension is defined as blood pressure that remains above goal in spite of concurrent use of 3 antihypertensive agents of different classes. Resistant hypertension is defined in order to identify patients who are at risk of having secondary causes of hypertension, and who may benefit from specific diagnostic and therapeutic applications. Despite the fact that OSA is listed as one of the causes of resistant HT , paucity of works has demonstrated the magnitude of problems of untreated OSA in subjects with resistant HT. There is so far two study demonstrating the beneficial effect of CPAP treatment in subjects with resistant HT, though both studies were flawed by not including the control group, no randomization and limited sample size. We aim at conducting a randomized controlled study to explore the beneficial effect of CPAP treatment in subjects with OSA and resistant hypertension.

Enrollment

92 patients

Sex

All

Ages

18 to 65 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age 18 - 65
known hypertension on ≧ 3 anti-hypertensive drugs
Apnea-hypopnea index ≧15
able to give informed written consent

Exclusion criteria

moderate renal impairment (glomerular filtration rate <30 mL/min/m2 )
endocrine/renal/cardiac causes of secondary HT
congestive heart failure and clinically fluid overloaded
On drugs that elevates BP e.g. NSAID, steroid
Non-compliance to anti-hypertensive medications
Unstable medical conditions such as unstable angina, recent myocardial infarction/stroke within 3 months
Active inflammatory/infective conditions e.g. rheumatoid arthritis
Excessive sleepiness that can be risky e.g. occupational driver, machine operator
Modification/changes of anti-hypertensive regimen within 8 weeks