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The role of compliance with positive airway pressure use on blood pressure in patients with obstructive sleep apnea: Is longer use a key-factor?

Background: Scientific data about the effects of positive airwaypressure (PAP) treatment on blood pressure (BP) control are continuously increasing; however they are controversial. Aims: We aimed to determine the long term effects of compliance with PAP therapy on BP in both hypertensive and normotensive patientswith OSAHS. Methods: One thousand one hundred sixty eight consecutive patients with newly diagnosed OSAHS, who have been recommended PAP therapy, were followed up for a minimum of 2 years. Patients with previous cardiovascular disease were excluded. BP was measured at baseline and after 2 years of PAP treatment. In addition, the correlation between the changes in BP with different levels of PAP compliance was assessed. Results: At the end ofthe follow-up period, in the hypertensive group of patients (n=586), a significant decrease was shown in systolic (-11.2 mm Hg, p r =0.14, p=0.002 and r=0.1, p=0.025, respectively) was observed in the whole group of patients. Conclusions: Long-term use of PAP treatment as well as increased hours of PAP use showed significant reductions in BP not only in patients with OSAHS and hypertension, but also in normotensive patients. Therefore a significant potential reduction in cardiovascular mortality and morbidity should be expected in these patients.