Lowering Blood Pressure in Patients with Obstructive Sleep Apnea and Resistant Hypertension

Patients with resistant hypertension (i.e., requiring ≥3 antihypertensive medications for even partial blood pressure [BP] control) often have obstructive sleep apnea (OSA). Small studies suggest that the usual treatment for OSA — continuous positive airway pressure (CPAP) — lowers BP in patients with resistant hypertension. In this multicenter trial, researchers in Spain randomized 194 adults (mean age, 56; 70% men) with resistant hypertension and OSA (mean apnea-hypopnea index, 40.4 events per hour) to CPAP or no OSA treatment.

At 12 weeks, CPAP patients, compared with control patients, had significantly greater reductions from baseline in 24-hour mean BP (3.1 mm Hg more) and 24-hour diastolic BP (3.2 mm Hg more) but not in 24-hour systoli…