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CPAP for Apnea Linked to Lower Incident Hypertension

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Pay More Attention to Sleep Apnea

Both of these studies significantly advance our understanding and support a causal link between obstructive sleep apnea and the development of hypertension, said Dr. Vishesh K. Kapur and Dr. Edward M. Weaver.

Sleep apnea deserves greater attention from clinicians, especially for patients who have hypertension or are at risk of developing it. It is a potentially treatable cause that may well respond to CPAP, they said.

Dr. Kapur is in the department of medicine and the sleep center at the University of Washington, Seattle. Dr. Weaver is in the department of otolaryngology–head and neck surgery and the sleep center at the university, as well as in the surgery service at the VA Medical Center in Seattle. Dr. Kapur reported ties to Merck, Johnson & Johnson, and Bristol-Myers Squibb; Dr. Weaver reported no potential financial conflicts of interest. These remarks were taken from their editorial comment accompanying the JAMA reports (JAMA 2012;307:2197-8).


 

FROM JAMA

This analysis showed that CPAP was associated with a significantly reduced rate of incident HT and CV events as long as patients received 4 hours or more of the treatment each night (JAMA 2012;307:2161-8).

However, as the conclusion of a post hoc analysis, this result must be considered "hypothesis-generating" rather than definitive, they noted.

In addition, Dr. Barbe and his associates realized that they had erred in designing the study and that it likely had insufficient statistical power to detect a significant difference in the rate of HT. "A larger study or longer follow-up might have been able to identify a significant association between treatment and outcome," they said.

Dr. Marin’s study was supported by Instituto Carlos III; the Ministry of Health, Madrid; and the Spanish Society of Respiratory Medicine. Dr. Barbe’s study was funded by Instituto de Salud Carlos III, the Spanish Respiratory Society, Resmed, Air Products-Carburos Metalicos, Respironics, and Breas Medical. Dr. Marin, Dr. Barbe, and their associates reported no financial conflicts of interest.

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