Hypertension, Obstructive Sleep Apnea
Conditions
Keywords
Continuous airway pressure, Hypertension, Obstructive sleep apnea
Brief summary
The purpose of this study is to examine the effect on blood pressure of 3 months of treatment with continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA). Hypothesis: 1. Central 24-h blood pressure (BP) monitoring hedges day fluctuations in blood pressure more accurately than peripheral 24-h BP monitoring, because the measurement is painless and does not interfere with the patient / subject's activities during the daytime or nighttime sleep. 2. Blood pressure is elevated in patients with OSA and falls during treatment with CPAP. 3\. The renal treatment of salt and water is abnormal in OSA, improved during treatment with CPAP. 4\. Quality of life improves during treatment with CPAP
Detailed description
Approximately 20 patients with hypertension and moderate to severe OSA are treated with CPAP 3 months to examine the treatment effect on blood pressure throughout the day, but especially nocturnal, renal treatment of salt and water, and quality of life. Before and after 3 months of CPAP treatment is made central and peripheral 24-h ambulatory blood pressure monitoring, 24-h urine collection and blood samples.
Interventions
DEVICECPAP
3 months of CPAP treatment
Sponsors
Erling Bjerregaard Pedersen
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
55 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* chronic kidney disease (CKD stage I and II), eGFR 60-90 ml/min/1.73 m2 or eGFR\> 90 ml/min/1.73 m2 and proteinuria or other signs of kidney damage. * Obstructive sleep apnea, apnea hypopnea index (AHI) \> 15 (moderate to severe) * Both men and women * 55-70 years * Signed consent form
Exclusion criteria
* Lack of desire to participate * Malignant disease * Abuse of drugs or alcohol * Pregnant and breastfeeding * Incompensated heart failure * Atrial fibrillation * Liver disease (Alanine aminotransferase (ALT) \> 200) * Severe chronic obstructive pulmonary disease (Forced expiratory volume in 1 second \<50% predicted) * Blood pressure difference between the right and left arm\> 10/10 mmHg
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| difference in systolic peripheral BP at night | 3 months | The difference in systolic BP at night by peripheral BP days before and after 3 months of treatment of OSA with CPAP in patients with hypertension. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Difference i BP throughout the day | 3 months | The difference in systolic BP and diastolic BP throughout the day, in the daytime and in nighttime between measurements with peripheral and central 24-h blood pressure monitoring before and after 3 months of treatment with CPAP. |
| Correlation between degree of OSA and kidney function on effect of treatment | 3 months | The correlation between the treatment effect on blood pressure levels on the one hand and the severity of OSA prior to initiation of treatment and renal function as measured by estimated glomerular filtration rate (eGFR) on the other. |
| Difference i central systolic BP | 3 months | The difference in systolic BP at night in central BP days before and after 3 months of treatment of OSA with CPAP in patients with hypertension. |
| Plasma renin concentration (PRC), plasma angiotensin II (p-AngII), plasma aldosterone (p-Aldo), plasma vasopressin (P-AVP) and plasma endothelin (p-endothelin). | 3 months | Changes in PRC, p-AngII, p-Aldo. P-AVP and p-endothelin in blood samples before and after 3 month of treatment. |
| Quality of life | 3 months | Changes in the quality of life before and after treatment of OSA with CPAP. |
| urine auquaporine2 (u-AQP2) and urine epithelial Natrium channel (u-ENaC) | 3 months | Changes in U-AQP2 and u-ENaC in 24-h urine samples before and after 3 month of treatment. |
Countries
Denmark
Outcome results
None listed