Paradoxical reaction of blood pressure on sleep apnoea XXXX treated with Positive Airway Pressure.

@entity1 @entity551 @entity27 @entity101
INTRODUCTION: @entity27 ( @entity27 ) @entity1 may develop @entity101 and Positive Airway Pressure (PAP) is an effective treatment in blood pressure (BP) control. OBJECTIVES: Analyse a hypertensive @entity27 population with unexpected @entity551 after PAP usage and verify correlations between @entity551 , either with @entity27 severity index or nocturnal ventilatory support compliance. METHODS: Descriptive, retrospective analysis of 30 @entity1 with PAP treated OSA, for one year, on average, and with previous controlled @entity101 , who developed a rise in BP, defined as augmentation of > 5 mmHg in systolic (SBP) and/or diastolic BP (DBP), after PAP usage. Co-relational analysis of BP increase, with @entity27 severity indexes and therapy compliance, using Pearson coefficient. RESULTS: Of 508 consecutive @entity1 followed in our Department, treated with nocturnal ventilatory support, 30 evolved with @entity551 after initiating treatment (age 58    10.8 years; Apnoea-Hypopnoea Index [AHI], 46.1    18.68). After PAP usage, mean blood pressure (MBP), Systolic BP (SBP) and @entity551 was 16    15 mmHg, 20    25 mmHg and 6    19.4 mmHg, respectively. No @entity1 showed significant BMI increase. Epworth Sleepiness Scale (ESS) value decreased 8.9    5.48 points. MBP, SBP and DBP variations were not correlated with P90/P95, residual AHI, leaks or PAP compliance. CONCLUSIONS: No specific characteristics were identified in the group who developed a rise in BP with PAP usage. No correlations were found between rises in BP and @entity27 severity indexes or PAP compliance. Neither BMI nor variation in wakefulness status explained the rise in BP. Studies relate polymorphisms of b1-adrenoreceptors with different BP responses to ventilatory support. More studies are needed to clarify the cause of this paradoxical response.
