Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 Feb 1;39(2):302-309.
doi: 10.1097/HJH.0000000000002664.

The HIPARCO-2 study: long-term effect of continuous positive airway pressure on blood pressure in patients with resistant hypertension: a multicenter prospective study

Cristina Navarro-Soriano  1 , Gerard Torres  2 , Ferrán Barbé  3   4 , Manuel Sánchez-de-la-Torre  5   4 , Pedro Mañas  6   4 , Patricia Lloberes  7   4 , Trinidad Díaz Cambriles  8 , María Somoza  9 , Juan F Masa  10   4 , Mónica González  11 , Eva Mañas  12 , Mónica de la Peña  13 , Francisco García-Río  14   4 , Josep María Montserrat  15   4 , Alfonso Muriel  16 , Grace Oscullo  1 , Alberto García-Ortega  1 , Tomás Posadas  1 , Francisco Campos-Rodríguez  17   4 , Miguel-Ángel Martínez-García  1   4 ; on behalf the Spanish Sleep Network
Affiliations
Multicenter Study

The HIPARCO-2 study: long-term effect of continuous positive airway pressure on blood pressure in patients with resistant hypertension: a multicenter prospective study

Cristina Navarro-Soriano et al. J Hypertens. .

Abstract

Introduction: Short-term treatment with continuous positive airway pressure (CPAP) produces a clinically significant reduction in blood pressure (BP) in patients with obstructive sleep apnea (OSA) and resistant hypertension. However, it is unknown whether this effect continues over the long-term. Our objective was to assess the effect of long-term CPAP on BP in patients with OSA and resistant hypertension.

Methods: The study included 161 patients diagnosed with both OSA [apnea--hypopnea index (AHI) ≥15] and resistant hypertension diagnosed via 24-hour ambulatory BP measurement (24-h ABPM), in whom a second analysis via 24-h ABPM was performed at the end of the follow-up.

Results: Patients were followed up within 59 months [interquartile range (IQR): 44-70]. CPAP treatment was prescribed to 82% of the patients (70% with good adherence to CPAP defined as use of CPAP at least 4 h/night). A comparison between the adherent group and nonadherent group (including those with CPAP not prescribed) showed that CPAP adherents had a significant drop in the 24-h BP, both systolic [-3.9 mmHg; 95% confidence interval (CI): -8.1 to 0.3] and diastolic pressure (-3.5 mmHg [95% [CI]: -6.4-0.5]), with a higher magnitude during the night (-5.5 and -4.9 mmHg, respectively). The CPAP adherent group needed a mean of 1.1 less antihypertensive drugs (particularly spironolactone). Finally, there was a positive correlation between the drop in 24-h SBP and the hours of CPAP use (r = 0.24; P = 0.01).

Conclusion: Good adherence to long-term CPAP treatment largely succeeded in significantly reducing BP in those patients with OSA and resistant hypertension, despite the use of a lower number of antihypertensive drugs.

PubMed Disclaimer

Comment in

References

    1. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in Hypertension. 2018 Jun;71(6):e136-e139] [published correction appears in Hypertension. 2018 Sep;72(3):e33]. Hypertension 2018; 71:1269–1324.
    1. Persell SD. Prevalence of resistant hypertension in the United States, 2003–2008. Hypertension 2011; 57:1076–1080.
    1. Kumbhani DJ, Steg PG, Cannon CP, Eagle KA, Smith SC, Crowley K, et al. REACH Registry Investigators. Resistant hypertension: a frequent and ominous finding among hypertensive patients with atherothrombosis. Eur Heart J 2013; 34:1204–1214.
    1. Pierdomenico SD, Lapenna D, Bucci A, Di Tommaso R, Di Mascio R, Manente BM, et al. Cardiovascular outcome in treated hypertensive patients with responder, masked, false resistant, and true resistant hypertension. Am J Hypertens 2005; 18:1422–1428.
    1. Salles GF, Cardoso CRME, Muxfeldt ES. Prognostic influence of office and ambulatory blood pressures in resistant hypertension. Arch Intern Med 2016; 168:2340–2346.

Publication types

LinkOut - more resources