Acute Effects of Nasal Continuous Positive Airway Pressure on 24-Hour Blood Pressure and Catecholamines in Patients with Obstructive Sleep Apnea.

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  • MINEMURA Hiroshi
    The First Department of Internal Medicine, Nihon University School of Medicine
  • AKASHIBA Tsuneto
    The First Department of Internal Medicine, Nihon University School of Medicine
  • YAMAMOTO Hitoshi
    The First Department of Internal Medicine, Nihon University School of Medicine
  • AKAHOSHI Toshiki
    The First Department of Internal Medicine, Nihon University School of Medicine
  • KOSAKA Naoko
    The First Department of Internal Medicine, Nihon University School of Medicine
  • HORIE Takashi
    The First Department of Internal Medicine, Nihon University School of Medicine

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To assess the acute effects of nasal continuous positive airway pressure (CPAP) on the 24-hour blood pressure and the secretion of catecholamines in urine and plasma, we investigated the changes in the 24-hour blood pressure and urinary and plasma concentrations of epinephrine (E) and norepinephrine (NE) in 26 men with obstructive sleep apnea (OSA) with and without nasal CPAP. Nasal CPAP resulted in significant decreases in the daytime diastolic pressure (from 86 ± 16 mmHg to 83 ± 12 mmHg), the nighttime diastolic pressure (from 81 ± 12 mmHg to 77 ± 9 mmHg) and the nighttime systolic pressures (from 125 ± 15 mmHg to 120 ± 10 mmHg). There was no significant difference between patients with and without CPAP in the daytime or nighttime urinary E level, but patients who received CPAP showed a significant decrease in daytime urinary NE level (from 156 ± 112 μg/14h to 119 ± 101 μg/14h) and nighttime urinary NE level (from 143 ± 91 μg/10h to 112 ± 65 μg/10h). The morning plasma level of NE also decreased (from 371 ± 181 pg/ml to 273 ± 148 pg/ml) in patients who received nasal CPAP (p<0.02), but the plasma level of E remained unchanged. There were no correlations between PSG parameters and the reductions in blood pressure and the catecholamine levels induced by nasal CPAP. These findings suggest that OSA contributes, at least in part, to the development of systemic hypertension by increasing sympathetic nervous activity.<br>(Internal Medicine 37: 1009-1013, 1998)

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  • Internal Medicine

    Internal Medicine 37 (12), 1009-1013, 1998

    一般社団法人 日本内科学会

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