ABSTRACT Objective Continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) results in a modest reduction in blood pressure. This study aimed to identify parameters from 24‐h ambulatory blood pressure monitoring (ABPM) that are predictive of treatment response. Methods Treatment‐naïve patients with OSA were prospectively recruited from the Centre for Sleep Medicine and Science at Beijing Anzhen Hospital between July 2023 and April 2025. All participants underwent 24‐h ABPM assessments before and after 3‐month CPAP therapy. Correlations between the baseline ABPM data and post‐CPAP changes in blood pressure were analyzed. Multivariate analysis was used to determine whether specific baseline blood pressure cutoffs independently predicted a clinically significant reduction in blood pressure. Results Good CPAP adherence (median usage: 6.1 h/night and 6.0 days/week; residual apnea–hypopnea index: 1.7 events/h) was achieved among 51 recruited patients (92.2% male, median age 40.5 years). After 3 months of CPAP treatment, significant reductions were observed in nearly all blood pressure measurements. Baseline 24‐h mean arterial pressure (MAP) was positively correlated with the reduction in all 24‐h blood pressure measures, all nighttime blood pressure measures, and daytime MAP. Compared with patients with 24‐h MAP < 96 mmHg, those with baseline 24‐h MAP ≥ 96 mmHg experienced relatively high absolute and relative reductions in all blood pressure measures. Conclusions Baseline 24‐h MAP effectively predicts blood pressure reduction following CPAP therapy in patients with OSA, demonstrating the clinical value of an ABPM‐guided strategy for managing patients with comorbid OSA and hypertension. Trial Registration: ChiCTR2300067728
Jiao et al. (Thu,) studied this question.