systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.26442/2075-082X_2018.2.77-78systhiper-550Research ArticleСТАТЬИARTICLESСИПАП-терапия у пациентов с синдромом обструктивного апноэ сна и артериальной гипертонией: мнение экспертовContinuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea syndrome and arterial hypertension: expert opinionЛитвинА. Ю.LitvinA. Yu.alelitvin@yandex.ruЕлфимоваЕ. М.ElfimovaE. M.eelfimova@gmail.comЧазоваИ. Е.ChazovaI. E.c34h@yandex.ruФГБУ «НМИЦ кардиологии»РоссияA.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian FederationRussian Federation2018231220221527778Copyright © Литвин А.Ю., Елфимова Е.М., Чазова И.Е., 20222022Литвин А.Ю., Елфимова Е.М., Чазова И.Е.Litvin A.Y., Elfimova E.M., Chazova I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/550

Сочетание синдрома обструктивного апноэ сна (СОАС) и артериальной гипертонии (АГ) является распространенной проблемой, затрагивающей как медицинские, так и социальные аспекты жизни больного. СИПАП-терапия является основным методом лечения нарушений дыхания во сне. Настоящий документ сфокусирован на современных данных о взаимосвязи СОАС и АГ и работах, оценивающих влияние СИПАП-терапии на артериальное давление, риск сердечно-сосудистых осложнений и качество жизни пациентов.

The combination of the obstructive sleep apnea (OSA) syndrome and arterial hypertension (AH) is a common problem affecting both the medical and social aspects of a patient's life. CPAP-therapy is the main treatment of sleep-discorded breathing. This paper focuses on up-to-date data on the relationship between OSA and AH and reviews studies evaluating the effect of CPAP-therapy on blood pressure, the risk of cardiovascular complications and the quality of life of patients.

синдром обструктивного апноэ снаартериальная гипертонияартериальное давлениеСИПАП-терапияobstructive sleep apnea syndromearterial hypertensionblood pressureCPAP-therapyReferencesPeppard P.E, Young T, Barnet J.H et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013; 177: 1006-14.Peppard P.E, Young T, Barnet J.H et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013; 177: 1006-14.Linz D, Woehrle H, Bitter T et al. The importance of sleep-disordered breathing in cardiovascular disease. Clin Res Cardiol 2015; 104: 705-18.Linz D, Woehrle H, Bitter T et al. The importance of sleep-disordered breathing in cardiovascular disease. Clin Res Cardiol 2015; 104: 705-18.Coccagna G, Mantovani M, Brignani F et al. Continuous recording of the pulmonary and systemic arterial pressure during sleep in syndromes of hypersomnia with periodic breathing. Bull Physiopathol Respir (Nancy) 1972; 8: 1159-72.Coccagna G, Mantovani M, Brignani F et al. Continuous recording of the pulmonary and systemic arterial pressure during sleep in syndromes of hypersomnia with periodic breathing. Bull Physiopathol Respir (Nancy) 1972; 8: 1159-72.Javaheri S, Drager L.F, Lorenzi-Filho G. Principles and Practices of Sleep Medicine, Sleep and cardiovascular disease: present and future. 6th edition. Eds M.H.Kryger, T. Roth, W.C.Dement. Philadelphia: Elsevier, 2017; p. 1222-28.Javaheri S, Drager L.F, Lorenzi-Filho G. Principles and Practices of Sleep Medicine, Sleep and cardiovascular disease: present and future. 6th edition. Eds M.H.Kryger, T. Roth, W.C.Dement. Philadelphia: Elsevier, 2017; p. 1222-28.Calhoun D.A. Obstructive sleep apnea and hypertension. Curr Hypertens Rep 2010; 12: 189-95.Calhoun D.A. Obstructive sleep apnea and hypertension. Curr Hypertens Rep 2010; 12: 189-95.Bratton D.J, Stradling J.R, Barbé F et al. Effect of CPAP on blood pressure in patients with minimally symptomatic obstructive sleep apnoea: a meta-analysis using individual patient data from four randomised controlled trials. Thorax 2014; 69: 1128-35.Bratton D.J, Stradling J.R, Barbé F et al. Effect of CPAP on blood pressure in patients with minimally symptomatic obstructive sleep apnoea: a meta-analysis using individual patient data from four randomised controlled trials. Thorax 2014; 69: 1128-35.Bakker J.P, Edwards B.A, Gautam S.P et al. Blood pressure improvement with continuous positive airway pressure is independent of obstructive sleep apnea severity. J Clin Sleep Med 2014; 10: 365-9.Bakker J.P, Edwards B.A, Gautam S.P et al. Blood pressure improvement with continuous positive airway pressure is independent of obstructive sleep apnea severity. J Clin Sleep Med 2014; 10: 365-9.Alajmi M, Mulgrew A.T, Fox J et al. Impact of continuous positive airway pressure. therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung 2007; 185: 67-72.Alajmi M, Mulgrew A.T, Fox J et al. Impact of continuous positive airway pressure. therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung 2007; 185: 67-72.Fava C, Dorigoni S, Dalle Vedove F et al. Effect of CPAP on blood pressure in patients with OSA/hypopnea: a systematic review and meta-analysis. Chest 2014; 145: 762-71.Fava C, Dorigoni S, Dalle Vedove F et al. Effect of CPAP on blood pressure in patients with OSA/hypopnea: a systematic review and meta-analysis. Chest 2014; 145: 762-71.Montesi S.B, Edwards B.A, Malhotra A et al. The effect of continuous positive airway pressure treatment on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med 2012; 8: 587-96.Montesi S.B, Edwards B.A, Malhotra A et al. The effect of continuous positive airway pressure treatment on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med 2012; 8: 587-96.Bazzano L.A, Khan Z, Reynolds K et al. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension 2007; 50: 417-23.Bazzano L.A, Khan Z, Reynolds K et al. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension 2007; 50: 417-23.Haentjens P, Van Meerhaeghe A, Moscariello A et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007; 167: 757-64.Haentjens P, Van Meerhaeghe A, Moscariello A et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007; 167: 757-64.Mo L, He Q.Y. Effect of long-term continuous positive airway pressure ventilation on blood pressure in patients with obstructive sleep apnea hypopnea syndrome: a meta-analysis of clinical trials. Zhonghua Yi Xue Za Zhi 2007; 87: 1177-80.Mo L, He Q.Y. Effect of long-term continuous positive airway pressure ventilation on blood pressure in patients with obstructive sleep apnea hypopnea syndrome: a meta-analysis of clinical trials. Zhonghua Yi Xue Za Zhi 2007; 87: 1177-80.Liu L, Cao Q, Guo Z et al. Continuous positive airway pressure in patients with obstructive sleep apnea and resistant hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens 2016; 18: 153-8.Liu L, Cao Q, Guo Z et al. Continuous positive airway pressure in patients with obstructive sleep apnea and resistant hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens 2016; 18: 153-8.Muxfeldt E.S, Margallo V, Costa L.M et al. Effects of continuous positive airway pressure treatment on clinic and ambulatory blood pressures in patients with obstructive sleep apnea and resistant hypertension: a randomized controlled trial. Hypertension 2015; 65: 736-42.Muxfeldt E.S, Margallo V, Costa L.M et al. Effects of continuous positive airway pressure treatment on clinic and ambulatory blood pressures in patients with obstructive sleep apnea and resistant hypertension: a randomized controlled trial. Hypertension 2015; 65: 736-42.Iftikhar I.H, Valentine C.W, Bittencourt L.R et al. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertens 2014; 32: 2341-50.Iftikhar I.H, Valentine C.W, Bittencourt L.R et al. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertens 2014; 32: 2341-50.de Oliveira A.C, Martinez D, Massierer D et al. The antihypertensive effect of positive airway pressure on resistant hypertension of patients with obstructive sleep apnea: a randomized, double-blind, clinical trial. Am J Respir Crit Care Med 2014; 190: 345-7.de Oliveira A.C, Martinez D, Massierer D et al. The antihypertensive effect of positive airway pressure on resistant hypertension of patients with obstructive sleep apnea: a randomized, double-blind, clinical trial. Am J Respir Crit Care Med 2014; 190: 345-7.Martínez-García M.A, Capote F, Campos-Rodríguez F et al. for the Spanish Sleep Network Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: The HIPARCO randomized clinical trial. JAMA 2013; 310: 2407-15.Martínez-García M.A, Capote F, Campos-Rodríguez F et al. for the Spanish Sleep Network Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: The HIPARCO randomized clinical trial. JAMA 2013; 310: 2407-15.Pedrosa R.P, Drager L.F, de Paula L.K et al. Effects of OSA treatment on BP in patients with resistant hypertension: a randomized trial. Chest 2013; 144: 1487-94.Pedrosa R.P, Drager L.F, de Paula L.K et al. Effects of OSA treatment on BP in patients with resistant hypertension: a randomized trial. Chest 2013; 144: 1487-94.Lozano L, Tovar J.L, Sampol G et al. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. J Hypertens 2010; 28: 2161-8.Lozano L, Tovar J.L, Sampol G et al. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. J Hypertens 2010; 28: 2161-8.Elfimova E, Sukmarova Z, Rogoza A, Chazova I. Advantage Of Ambulatory Blood Pressure Monitoring Versus Clinical Blood Pressure Measurements In Control Of Goal BP Levels Achievement In Patients With Arterial Hypertension 2-3 Degree And Severe Obstructive Sleep Apnea Syndrome. Am J Respir Crit Care Med 185; 2012: A218.Elfimova E, Sukmarova Z, Rogoza A, Chazova I. Advantage Of Ambulatory Blood Pressure Monitoring Versus Clinical Blood Pressure Measurements In Control Of Goal BP Levels Achievement In Patients With Arterial Hypertension 2-3 Degree And Severe Obstructive Sleep Apnea Syndrome. Am J Respir Crit Care Med 185; 2012: A218.Kohler M, Stoewhas A.C, Ayers L et al. Effects of continuous positive airway plressure therapy withdrawal in patients with obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med 2011; 184: 1192-9.Kohler M, Stoewhas A.C, Ayers L et al. Effects of continuous positive airway plressure therapy withdrawal in patients with obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med 2011; 184: 1192-9.Shahrokh Javaheri et al. Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017 Feb 21; 69 (7): 841-58.Shahrokh Javaheri et al. Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017 Feb 21; 69 (7): 841-58.Thunström E, Manhem K, Rosengren A et al. Blood pressure response to losartan and continuous positive airway pressure in hypertension and obstructive sleep apnea. Am J Respir Crit Care Med 2016; 193: 310-20.Thunström E, Manhem K, Rosengren A et al. Blood pressure response to losartan and continuous positive airway pressure in hypertension and obstructive sleep apnea. Am J Respir Crit Care Med 2016; 193: 310-20.Chirinos J.A, Gurubhagavatula I, Teff K et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 2014; 370: 2265-75.Chirinos J.A, Gurubhagavatula I, Teff K et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 2014; 370: 2265-75.McEvoy R.D et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 2016; 375: 919-31.McEvoy R.D et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea. N Engl J Med 2016; 375: 919-31.

The authors declare that there are no conflicts of interest present.