Can CPAP Reduce High Blood Pressure?

Studies show that combining CPAP (continuous positive airway pressure) CPAP and weight loss therapies can significantly reduce high blood pressure among individuals diagnosed with obstructive sleep apnea. CPAP may be a common treatment for sleep apnea, but if it is done together with weight loss intervention, it can greatly reduce blood pressure.

Julio Chirinos, MD, of the University of Pennsylvania in Philadelphia, reported to the American College of Cardiology that the Consequences of Obstructive Sleep Apnea (COSA) trial research conducted showed that combining CPAP and weight loss intervention can significantly lower systolic blood pressure compared to CPAP alone or weight loss intervention alone. Weight loss intervention and CPAP reduced blood pressure by 14 mm Hg, while blood pressure was only reduced by 6 mm Hg and 2 mm Hg by weight loss intervention and CPAP respectively when used separately.

Chirinos told MedPage that sleep apnea of an obese person should not be the only focus of treatment. An obese person with sleep apnea is also expected to suffer from hypertension. He said that both sleep apnea and obesity should be controlled to lower a patient’s blood pressure.

By combining CPAP and weight loss intervention therapies, a patient can prevent sleep apnea, obesity and hypertension all at the same time.There are already several studies relating hypertension to sleep apnea and obesity, but no study has proven the worsening effects of both combined conditions on hypertension.

According to Chirinos, there are already trials conducted on how CPAP and weight loss intervention can help improve hypertension separately. However, there had been no previous trials to check the incremental effects of combining both weight loss intervention and CPAP to lower blood pressure.

Therefore, heand his colleagues conducted a study on how combining CPAP and weight loss can help reduce blood pressure. In their study, they compared the effects of CPAP therapy, weight loss intervention and combining CPAP and weight loss therapies to reduce blood pressure.

They studied and observed 181 individuals who are both obese and are suffering from sleep apnea. The patients either had CPAP therapy alone, weight loss therapy alone or both CPAP and weight loss therapies. Their study lasted for 24 weeks.

Chirinos and his colleagues made per-protocol analysis and intention-to-treat (ITT) analysis. As expected, those patients who underwent weight loss therapy lost weight and had a reduced body mass index (BMI). In their ITT analysis, the researchers did not observe a significant difference when it comes to the results of systolic blood reductions among the three groups.

However, with their per-protocol analysis, Chirinos reported that there was a significant reduction in arterial pressure with combination therapy compared to the two monotherapies. Brachial pulse pressure also improved more with the combination therapy.

Chirinos said that their findings can decrease cardiovascular risk in the population. However, he also noted that doing both weight loss and CPAP therapies can be a challenge.  During the duration of the study, they had a large team which included dietitians and many more specialists. Doing both weight loss and CPAP therapies can be very expensive and may not be feasible for general patients.