Effects of antihypertensive medication on hypertension in patients with sleep apnoea.

The present study was to investigate the effect of four different antihypertensive medications [atenolol, hydrochlorothiazide (HCTZ), isradipine and spirapril] on the blood pressure and metabolic state of 18 patients with obstructive sleep apnoea. All patients received each of the drugs for a period of 8 weeks according to a randomized crossover design. Although all of the medications decreased systolic blood pressure (SBP), only spirapril decreased SBP significantly (17 +/- 15 mmHg; p < 0.001). All of the medications decreased diastolic blood pressure (DBP) significantly, but spirapril produced the greatest reduction (5-8 vs 10 mmHg, respectively). Both HCTZ and isradipine increased fasting serum total cholesterol concentration (0.3 +/- 0.5 and 0.3 +/- 0.4 mmol/l, respectively; p < 0.05). Atenolol decreased fasting serum high-density lipoprotein (HDL)-cholesterol concentration significantly (0.12 +/- 0.15 mmol/l; p < 0.01). Both HCTZ and isradipine increased fasting serum glucose concentration significantly (0.7 +/- 0.8 mmol/l and 0.6 +/- 0.7 mmol/l, respectively; p < 0.01). No significant effect on serum lipid and glucose levels was observed with spirapril. On the basis of these results, spirapril was the best medication for hypertensive patients with obstructive sleep apnoea.

RCT Entities:   Population Interventions Outcomes