Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03246022
Other study ID # Huaian First People's Hospital
Secondary ID
Status Completed
Phase
First received
Last updated
Start date April 3, 2018
Est. completion date December 30, 2021

Study information

Verified date August 2021
Source Huai'an No.1 People's Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Observational [Patient Registry]

Clinical Trial Summary

Obstructive sleep apnea syndrome (OSAS) causes nocturnal chronic intermittent hypoxia (CIH) that contributes to the development of hypertension. CIH profiles, including the its length, speed and intensity were widely different in individuals. Until recently, the influence of OSAS-related IH profiles on hypertension development has not been fully explored. The present study aimed to investigate the effects of different CIH properties on blood pressure (BP) and short-term blood pressure variability (BPV) in severe OSAS patients. Continuous positive airway pressure (CPAP) prevents the airway collapse, avoids the occurrence of intermittent hypoxemia and arousal, is the preferred treatment for OSAS and has been widely used in clinical. In theory, CPAP maintains upper airway patency and preserves ventilation, thereby inhibits the chain reaction over activation of the sympathetic nervous system and blood pressure regulating mechanism, thus CPAP treatment have adequate scientific basis to cause a substantial reduction arterial blood pressure, but controlled studies showed either no effect or only a minor decrease in arterial blood pressure by 1.4 and 2.5 mmHg respectively.The current, which type of combination of hypertension OSA patients can obtain the best antihypertensive benefit from CPAP therapy is still under debate.


Description:

Nocturnal BP was continuously monitored via measurement of pulse transmit time (PTT). The value of apnea-related systolic BP elevation (△BP) was used to reflect short-term BPV. Beat-to-beat RR interval data were incorporated in polysomnography for heart rate variability analysis. LF/HF band ratio was compared between two groups which used to reflect sympatho-vagal balance. The length of the desaturation event was measured to the nearest 0.5 second (△t). The fall in SpO2 during apnea was calculated as the gap from start of the desaturation to the nadir of the desaturation. The rate of fall in SpO2 was counted as the change in the percentage of SpO2 per second (△SpO2 /△t) and expressed as oxygen desaturation rate (ODR), which reflected the speed and efficacy of oxygen desaturation during an apnea event. One hundred and two severe OSAS subjects were divided into two groups according to the their median ODR: faster ODR and slower ODR. In addtion,patient were categorized into three groups: Group l: systolic blood pressure index was less than 30% of AHI; Group 2: systolic blood pressure index was less than 60% but more than 30%; Group 3: systolic blood pressure index is more than 60% of AHI. The investigator would compare the effect of CPAP treatment on awake and sleep BP level at the first night and 2 weeks therapy among three groups. Moreover, whether or not the sympathetic-parasympathetic nerve balance and the renin-angiotensin-aldosterone system are different in three groups would also be evaluated. The main purpose of study is to confirm the OSA with hypertension and OSA secondary hypertension are two different concepts. Basis for the clinical treatment, the former, CPAP might have no effect or only a minor decrease in arterial blood pressure, while the latter CPAP treatment might achieve significant antihypertensive effect.


Recruitment information / eligibility

Status Completed
Enrollment 78
Est. completion date December 30, 2021
Est. primary completion date December 30, 2021
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years to 70 Years
Eligibility Inclusion Criteria: 1. BP=180/110mmHg,but=140/90mmHg 2. without taking oral antihypertensive drugs. Exclusion criteria. (1) patients who had been hospitalized for cardiac or respiratory exacerbation<6wk prior to recruiting; (2) with autonomic nervous system diseases or endocrine disorders which might influence BP; (3) unwilling to participate in the study.

Study Design


Related Conditions & MeSH terms


Intervention

Other:
continuous positive airway pressure
Continuous positive airway pressure (CPAP) prevents the airway collapse, avoids the occurrence of intermittent hypoxemia and arousal, is the preferred treatment for OSAS and has been widely used in clinical. The investigator would compare the effect of CPAP treatment on awake and sleep BP level at the first night and 2 weeks therapy among three groups. Moreover, whether or not the sympathetic-parasympathetic nerve balance and the renin-angiotensin-aldosterone system are different in three groups would also be evaluated.

Locations

Country Name City State
China Department Of Respiratory Medicine,Huai'an First People's Hospital,Nanjing Medical University Huai'an Jiangsu

Sponsors (2)

Lead Sponsor Collaborator
Huai'an No.1 People's Hospital The First Affiliated Hospital with Nanjing Medical University

Country where clinical trial is conducted

China, 

Outcome

Type Measure Description Time frame Safety issue
Primary awake systolic blood pressure(SBP)changes as the mean systolic blood pressure measurements during a supine resting period of 1 0minute at awake state change from Baseline Systolic Blood Pressure at 2 weeks
Primary sleep systolic blood pressure(SBP)changes as the average of systolic blood pressure values during sleep change from Baseline Systolic Blood Pressure at 2 weeks
Primary sympathetic-parasympathetic nerve balance changes Studies using spectral analysis of R-R intervals have reported that the power spectrum contains both low-frequency(LF,0.04-0.15 Hz)and high-frequency peaks(HF,0.15-0.5Hz),HF power reflects parasympathetic activity,whereas LF power primarily reflects sympathetic activity with a parasympathetic component.The LF-to-HF ratio(LF/HF)is commonly regarded as an index of sympathovagal balance change from Baseline Systolic Blood Pressure at 2 weeks
Primary renin-angiotensin-aldosterone systemchanges as the levels of plasma angiotension ?( Ang I) and angiotension ?( Ang ?) before and after CPAP treatment change from Baseline Systolic Blood Pressure at 2 weeks
Primary AHI changes the combined number of apnea and hypopnea episodes per hour of sleep change from Baseline Systolic Blood Pressure at 2 weeks
Primary TST90 changes percentage of sleep time with oxygen saturation < 90% change from Baseline Systolic Blood Pressure at 2 weeks
Primary oxygen desaturation index(ODI) changes oxygen desaturation index change from Baseline Systolic Blood Pressure at 2 weeks
Primary event-related systolic blood pressure elevation (?SBP) changes as the gap between the peak value of postapneic SBP and lowest SBP during a obstructive respiratory event change from Baseline Systolic Blood Pressure at 2 weeks
Primary systolic blood pressure(SBP)index as the number of ?SBP>10mmHg per hour of sleep time. change from Baseline Systolic Blood Pressure at 2 weeks
Primary Desaturation rate The rate of fall in SpO2 was counted as the change in the percentage of SpO2 per second during apnea one night
See also
  Status Clinical Trial Phase
Completed NCT05539443 - Telehealth-Enhanced Assessment and Management After Stroke-Blood Pressure N/A
Active, not recruiting NCT03753633 - Efficiency of Speech Therapy in Resistant Hypertensive Patients With Mild Obstructive Sleep Apnea Syndrome N/A
Active, not recruiting NCT04646902 - Kynurenine/Tryptophan Ratio in Hypertension Associated to Obstructive Sleep Apnea
Completed NCT03155139 - Primary Aldosteronism In Hypertensive Patients in China
Completed NCT03105531 - Screening for Primary Aldosteronism in a Population of Patients With Hypertension