Key result
Continuous positive airway pressure therapy significantly reduced very short-term blood pressure variability compared to baseline in patients with sleep-disordered breathing.
Why the study?
Blood pressure variability predicts cardiovascular outcomes independently of absolute values, but the effects of continuous positive airway pressure on very short-term blood pressure variability in sleep-disordered breathing were unknown.
Does continuous positive airway pressure (CPAP) reduce very short-term blood pressure variability in patients with newly diagnosed sleep-disordered breathing?
Does continuous positive airway pressure (CPAP) reduce very short-term blood pressure variability in patients with newly diagnosed sleep-disordered breathing?
CPAP therapy effectively reduces very short-term blood pressure variability in patients with sleep-disordered breathing, suggesting a potential mechanism for its cardiovascular benefits.
BACKGROUND: Blood pressure (BP) variability (BPV) is a predictor of cardiovascular outcomes independently of BP absolute values. We previously reported that pulse transit time (PTT) enables monitoring beat-to-beat BP, identifying a strong relationship between the extent of very short-term BPV and the severity of sleep-disordered breathing (SDB). Here, we investigated the effects of continuous positive airway pressure (CPAP) on very short-term BPV. METHODS: We studied 66 patients (mean age 62 years old, 73% male) with newly diagnosed SDB who underwent full polysomnography on two consecutive days for diagnosis (baseline) and CPAP, together with PTT-driven BP continuous recording. PTT index was defined as the average number of acute transient rises in BP (≥12 mmHg) within 30 s/h. RESULTS: CPAP treatment effectively improved SDB parameters, and attenuated PTT-based BP absolute values during the night-time. Very short-term BPV that includes PTT index and standard deviation (SD) of systolic PTT-BP was significantly reduced by CPAP therapy. The changes in PTT index from baseline to CPAP were positively correlated with the changes in apnea-hypopnea index, obstructive apnea index (OAI), oxygen desaturation index, minimal SpO 2 , and mean SpO 2 . Multivariate regression analysis revealed that changes in OAI and minimal SpO 2 , as well as heart failure, were the independent factors in determining the reduction of PTT index following CPAP. CONCLUSION: PTT-driven BP monitoring discovered the favorable effects of CPAP on very short-term BPV associated with SDB events. Targeting very short-term BPV may be a novel approach to identifying individuals who experience greater benefits from CPAP.
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Misaka et al. (2023) studied Sleep-disordered breathing (n=66). Continuous positive airway pressure (CPAP) vs. Baseline (no CPAP) was evaluated on Very short-term blood pressure variability (PTT index and standard deviation of systolic PTT-BP). Continuous positive airway pressure therapy significantly reduced very short-term blood pressure variability compared to baseline in patients with sleep-disordered breathing.
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