Obstructive Sleep Apnea Clinical Trial
— Masked-OSAOfficial title:
Effect of Intervention With Continuous Positive Pressure (CPAP) on Nocturnal Blood Pressure (BP) in Patients With Masked Hypertension and Sleep Apnea
Verified date | November 2023 |
Source | Sociedad Española de Neumología y Cirugía Torácica |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The general objective is to evaluate the effect of continuous positive airway pressure (CPAP) treatment in patients with masked hypertension. The secondary objectives are: i) To evaluate the prevalence of different circadian patterns of BP in ambulatory blood pressure monitoring (ABPM) (dipper / non-dipper); ii) To assess in these patients the relationship between compliance with CPAP treatment and the response to nocturnal BP; iii) To identify variables of the ABPM, and biomarkers that are related to the unfavourable pattern of nocturnal BP response in these patients treated with CPAP; iv) To evaluate the change in the profile of biomarkers with the treatment. Methodology: Open, parallel, prospective, randomized and controlled study in which an ABPM will be performed in individuals with masked hypertension referred to the sleep unit and diagnosed of OSA (AHI≥ 30) without sleepiness (Epworth≤18). A total of 64 subjects with OSA and masked hypertension will be recruited. It will be collected blood for the determination of biomarkers. Subsequently, they will be randomized to receive treatment with CPAP (32) or conservative treatment (32). After 3 months of initiation, ABPM and biological determinations will be repeated.
Status | Completed |
Enrollment | 16 |
Est. completion date | October 31, 2023 |
Est. primary completion date | January 31, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 100 Years |
Eligibility | Inclusion Criteria: 1. Men and women over 18 years of age 2. Referred to the sleep unit for suspected OSA 3. Being masked hypertensive and presenting an AHI= 30 in the sleep study 4. Signature of the informed consent. Exclusion Criteria: 1. Previous CPAP treatment 2. Significant somnolence defined by an Epworth Sleepiness Scale (ESS) score higher than 18 3. Psychophysical inability to complete questionnaires 4. Previous diagnosis or suspicion of another sleep disorder 5. Presence of more than 50% of central apneas or Cheyne-Stokes respiration 6. Having a serious chronic disease: neoplasia, renal failure, severe chronic obstructive pulmonary disease, chronic depression and other chronic limiting diseases 7. Medical history that may interfere with the objectives of the study or, in the opinion of the researcher, may compromise the conclusions 8. Any medical, social or geographical factor that may endanger the patient's compliance 9. Having a profession of high risk (professional driver). |
Country | Name | City | State |
---|---|---|---|
Spain | Hospital Universitari Arnau de Vilanova | Lleida |
Lead Sponsor | Collaborator |
---|---|
Sociedad Española de Neumología y Cirugía Torácica |
Spain,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Effect of CPAP treatment on BP in masked hypertensive patients with severe OSA | Change in mmHg in the blood pressure of the ambulatory blood pressure monitoring parameters after the treatment | 3 years | |
Secondary | Prevalence of the different circadian BP patterns (dipper/no-dipper) in the ABPM of masked hypertensive subjects diagnosed with severe OSA without significant somnolence (Epworth=18) | The prevalence of each circadian patterns will be calculated from the baseline ambulatory blood pressure monitoring data | 3 years | |
Secondary | Association between CPAP use and blood pressure change in ABPM | The relation between CPAP compliance (hours/night) and changes in mean nighttime BP (mmHg) between baseline and at 3-months in ABPM measurements will be assesed | 3 years | |
Secondary | Ambulatory blood pressure parameters that could be related to the response to CPAP treatment | Using all the ABPM variables we will proceed to the identification of variables that are related to the change in mean nocturnal BP in patients treated with CPAP | 3 years | |
Secondary | Changes in the biomarkers' profile (mRNAs) after CPAP treatment | Using the blood samples obtained in the baseline and 3 months visit it will be evaluated possible changes in the biomarkers profile after CPAP treatment.
Learning Phase: complete profile analysis (754 miRNAs) will be carried out in 24 patients Learning Phase: complete profile analysis (754 miRNAs) will be carried out in 24 patients representative of the change in BP in treated patients. The miRNAs associated with the change in BP will be identified from the 754 miRNAs potentially present in serum and plasma. Validation Phase: Specific primers will be designed for the real-time PCR amplification of the genes for which we have found a significant association The miRNAs found will be analyzed after 3 months of treatment. Analysis of biomarkers. Immunoassay techniques will evaluate the following markers before and after treatment: angiotensin I, II and III, plasma renin activity, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and endogenous ouabain. |
3 years |
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