Key result
CPAP prevents blood pressure increases, keeping night-time diastolic BP 3.4 mmHg lower than usual care.
Why the study?
The effects of CPAP on blood pressure in normotensive individuals, especially those with a dipping blood pressure pattern, remain uncertain.
Does CPAP prevent blood pressure increases in normotensive individuals with severe obstructive sleep apnoea and a dipping BP pattern?
RCT (n=60)
Open-label
1:1
No
Does CPAP prevent blood pressure increases in normotensive individuals with severe obstructive sleep apnoea and a dipping BP pattern?
CPAP treatment prevents increases in blood pressure in normotensive patients with severe OSA and a dipping BP pattern, potentially preventing the onset of hypertension.
Answers are grounded in this paper and cite their sources.
Supports CPAP to prevent hypertension onset in normotensive severe OSA with dipping BP; extends prior RCT evidence to this subgroup.
BACKGROUND: The effects of continuous positive airway pressure (CPAP) on blood pressure (BP) in normotensive subjects, particularly among those with a dipping BP pattern, remain uncertain, raising questions about its indication for this group of patients. We assessed the impact of CPAP on BP in normotensive subjects with a dipping BP pattern and severe obstructive sleep apnoea (OSA). Patients were randomly assigned to receive either CPAP treatment or usual care for 12 weeks. The primary outcome was the change in ambulatory BP monitoring (ABPM) parameters from baseline to the 3-month follow-up. RESULTS: The 60 patients who completed the follow-up had a mean±sd age of 52.2±10.8 years and 40 (66.7%) were male. The intention-to-treat analysis showed no significant changes with CPAP, whereas the usual care group experienced increases in ABPM parameters. This resulted in a mean difference of -3.4 mmHg (95% CI -6.124- -0.676; p=0.015) in night-time diastolic BP between the groups. The per-protocol analysis indicated significant differences between the CPAP and usual care groups for all primary end-points, except for daytime systolic BP. For night-time systolic BP, the mean difference was -6.052 mmHg (95% CI -10.895- -1.208; p=0.016). CONCLUSION: These findings suggest a protective effect of CPAP, highlighting the importance of CPAP prescription for this population to control potential increases in BP and possibly prevent the onset of hypertension.
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Targa et al. (2025) conducted an RCT in Severe obstructive sleep apnoea with normotension and a dipping blood pressure pattern (n=60). Continuous positive airway pressure (CPAP) vs. Usual care (sleep hygiene advice and dietary counselling) was evaluated on Change in night-time diastolic blood pressure from baseline to 3 months (MD -3.4 mmHg, 95% CI -6.124 to -0.676, p=0.015). Continuous positive airway pressure prevented an increase in blood pressure, resulting in a significant mean difference of -3.4 mmHg in night-time diastolic BP compared to usual care.
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