BP increase after Starting CPAP treatment for sleep apnea 
Author Message
 BP increase after Starting CPAP treatment for sleep apnea

Can anyone rationalise why {*filter*} Pressure might INCREASE after
starting CPAP treatment for Obstructive Sleep Apnea.

Details.  Male,  age 63, slightly overweight, taking meds for 15 years
(Verapamil 240 mg once a day, Ziac 2.5/6.25 once a day) had normal BP
of 120/80 (averaged over 45 days prior to CPAP treatmet.  Variance
very slight. Two readings per measurement, same instrument, same cuff,
same arm.  Measured twice a day, mornings and evenings.Also takes 300
mg Allopurinol once a day to prevent the formation of uric acid kidney
stones.

After beginning CPAP treatment, all the POSITIVE effects were
experienced, but BP has increased by about 20-30 mm (systolic and
diastolic), with occasional spikes, in the late evening, to 200/130.
BP is much higher in the mornings and evenings, than in the afternoons
between 1400 and 1700 hrs.

Most studies I have seen say that BP is REDUCED after CPAP.

CPAP duration is now 8 weeks.

The local GP does not appear alarmed by this, and will, I am sure,
offer additional meds to assist.  A renowned cardiologist offered no
explanation, even though he is an associate of the sleep specialist,
but suggested adding 80 mg of Diovan, once a day, to treat the BP
increase.

Unfortunately, being a research scientist, I am also seeking an
explanation for this increase, as well as a treatment.

Any suggestions would be most welcome.

Geoff



Thu, 11 Mar 2004 07:29:37 GMT
 BP increase after Starting CPAP treatment for sleep apnea
Quote:

> Can anyone rationalise why {*filter*} Pressure might INCREASE after
> starting CPAP treatment for Obstructive Sleep Apnea.

> Details.  Male,  age 63, slightly overweight, taking meds for 15 years
> (Verapamil 240 mg once a day, Ziac 2.5/6.25 once a day) had normal BP
> of 120/80 (averaged over 45 days prior to CPAP treatmet.  Variance
> very slight. Two readings per measurement, same instrument, same cuff,
> same arm.  Measured twice a day, mornings and evenings.Also takes 300
> mg Allopurinol once a day to prevent the formation of uric acid kidney
> stones.

> After beginning CPAP treatment, all the POSITIVE effects were
> experienced, but BP has increased by about 20-30 mm (systolic and
> diastolic), with occasional spikes, in the late evening, to 200/130.
> BP is much higher in the mornings and evenings, than in the afternoons
> between 1400 and 1700 hrs.

> Most studies I have seen say that BP is REDUCED after CPAP.

> CPAP duration is now 8 weeks.

> The local GP does not appear alarmed by this, and will, I am sure,
> offer additional meds to assist.  A renowned cardiologist offered no
> explanation, even though he is an associate of the sleep specialist,
> but suggested adding 80 mg of Diovan, once a day, to treat the BP
> increase.

> Unfortunately, being a research scientist, I am also seeking an
> explanation for this increase, as well as a treatment.

> Any suggestions would be most welcome.

> Geoff

*************************************************************************
Geoff,

It is a very interesting case. Yes, you are correct that most studies
showed a reduction of {*filter*} pressure and myocardial relaxation
following initiation of CPAP. Did you exclude that maybe the settings
on the machine are too high? Another thing, just a side note:
Allopurinol+HCTZ may decrease renal function. Has that been checked?
What's the primary Dx? Just hypertension?

AGZ



Sun, 14 Mar 2004 10:17:08 GMT
 
 [ 2 post ] 

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