Effects of Positive Airway Pressure Treatment on Clinical Measures of Hypertension and Type 2 Diabetes

Prasad, Bharati; Carley, David W.; Krishnan, Jerry A.; Weaver, Terri E.; Weaver, Frances M.

doi:10.5664/jcsm.2136

Cited by 25 publications

(11 citation statements)

References 54 publications

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“…83 Furthermore, observational data suggests treatment of OSA with CPAP may result in greater reduction of blood pressure in African Americans compared to whites. 84 …”

Section: Introductionmentioning

confidence: 99%

Disparities and genetic risk factors in obstructive sleep apnea

2016

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Obstructive sleep apnea (OSA) is an increasingly prevalent condition. A growing body of literature supports substantial racial disparities in the prevalence, risk factors, presentation, diagnosis and treatment of this disease. Craniofacial structure among Asians appears to confer an elevated risk of OSA despite lower rates of obesity. Among African Americans, Native Americans, and Hispanics, OSA prevalence is increased, likely due in part to obesity. Burden of symptoms, particularly excessive daytime sleepiness, is higher among African Americans, though Hispanics more often report snoring. Limited data suggest African Americans may be more susceptible to hypertension in the setting of OSA. While differences in genetic risk factors may explain disparities in OSA burden, no definitive genetic differences have yet been identified. In addition to disparities in OSA development, disparities in OSA diagnosis and treatment have also been identified. Increased severity of disease at diagnosis among African Americans suggests a delay in diagnosis. Treatment outcomes are also suboptimal among African Americans. In children, tonsillectomy is less likely to cure OSA and more commonly associated with complications in this group. Among adults, adherence to continuous positive airway pressure (CPAP) is substantially lower in African Americans. The reasons for these disparities, particularly in outcomes, are not well understood and should be a research priority.

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“…83 Furthermore, observational data suggests treatment of OSA with CPAP may result in greater reduction of blood pressure in African Americans compared to whites. 84 …”

Section: Introductionmentioning

confidence: 99%

Disparities and genetic risk factors in obstructive sleep apnea

2016

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“…In an observational retrospective cohort study in patients with OSA and T2D, CPAP was associated with improvements in systolic (−6.81, 95% CI: −9.94 to −3.67 mmHg) and diastolic (−3.69, 95% CI: −5.53 to −1.85 mmHg) BP over 9-12 months period. 60 Similar reductions in BP levels were found after 3 months of CPAP in a RCT in which patients were randomised to early (<1 week) or late (1-2 months) 61 intervention.…”

Section: Osa and Hypertensionmentioning

confidence: 55%

Obstructive sleep apnoea in diabetes: Does it matter?

Tahrani

2017

Diabetes and Vascular Disease Research

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Obstructive sleep apnoea (OSA) is very common in patients with Type 2 diabetes (T2D), which is not surprising considering that obesity is a common risk factor for both conditions. In general population studies, OSA has been shown to be associated with several comorbidities including increased risk of road traffic accidents, T2D, hypertension and lack of nocturnal dipping of blood pressure, hyperlipidaemia, increased inflammation, increased risk of cardiovascular disease and mortality, increased risk of atrial fibrillation, worse quality of life, and erectile dysfunction. However, the impact of OSA on diabetes-related vascular and metabolic outcomes remains unclear. Furthermore, the impact of continuous positive airway pressure (CPAP) treatment in patients with T2D is also unclear. This unclarity regarding the impact of OSA and CPAP in patients with T2D has possibly contributed to the lack of screening for OSA in patients with T2D in the UK despite the high prevalence of OSA in patients with T2D. In this commentary, I provide an overview about OSA with a particular focus on its role and impact in patients with T2D.

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“…108 CPAP was associated with a mean BP change of -6.81/-3.69 mmHg over 9-12 months in a retrospective cohort database study of patients with newly diagnosed OSA and pre-existing hypertension or T2D. 109 CPAP lowered systolic and diastolic BP (149/80 mmHg to 140/73 mmHg, p=0.005/0.007) in another randomised trial. 97 As yet, the impact of CPAP on incident hypertension is unclear.…”

Section: Osa Is Associated With Erectile Dysfunctionmentioning

confidence: 95%

Obstructive sleep apnoea: a diabetologist’s perspective

Tahrani

2016

Br J Diabetes

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Obstructive sleep apnoea (OSA) is very common in patients with type 2 diabetes (T2D), which is unsurprising given that obesity is a major risk factor for both conditions. OSA has been associated with impaired quality of life, many cardiovascular disease (CVD) risk factors and cardiovascular disease in general. Continuous positive airway pressure treatment has beneficial impacts on CVD risk factors and CVD. However, the true impact of OSA in patients with T2D remains unclear. The International Diabetes Federation recommended routine screening for OSA in patients with T2D, but two-thirds of diabetes healthcare professionals were unaware of these recommendations. The aim of this review is to attempt to answer the following questions. Is OSA diagnosis and treatment important in patients with T2D and why? What is the relevance of OSA to the practising diabetologist? Br J Diabetes 2016;16:107-113

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Effects of Positive Airway Pressure Treatment on Clinical Measures of Hypertension and Type 2 Diabetes

Abstract: Treatment of OSA improves office blood pressure in hypertensive men. Prospective studies are necessary to better characterize specific populations with OSA that benefit from treatment with respect to progression of hypertension and type 2 diabetes.

Cited by 25 publications

References 54 publications

Disparities and genetic risk factors in obstructive sleep apnea

Disparities and genetic risk factors in obstructive sleep apnea

Obstructive sleep apnoea in diabetes: Does it matter?

Obstructive sleep apnoea: a diabetologist’s perspective

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