Comparison Of The Efficacy Between Continuous Positive Airway Pressure And Renal Artery Sympathetic Denervation By Radiofrequency Ablation In Obstructive Sleep Apnea Syndrome Patients With Hypertension

Objective:To compare the efficacy of continuous positive airway pressure (CPAP) and renal arterial sympathetic denervation (RSD) in patients with coexisting moderate to severe obstructive sleep apnea syndrome (OSAS) and hypertension.Methods:Retrospective analysis was conducted for patients with coexisting moderate to severe OSAS and hypertension for the efficacy of CPAP (CPAP group, n=16) and RSD (RSD group, n=15). Comparison was made for polysomnographic parameters and 24 hours ambulatory blood pressure (Bp) between two groups.Results:There was no significant difference in age, gender, body mass index, nocturnal apnea hypopnea index (AHI), mean and minimal pulse oxygen saturation (meanSpO2 and miniSpO2) between two groups. Compared with those at pre-treatment, the following changes were observed at Day 30 post-treatment:in CPAP group during treatment, nocturnal AHI was significantly reduced (5±3 vs 35 ±12, P<0.05), while meanSpO2 and miniSpO2 became significantly elevated (95.6% ±1.4% vs 93.6%±1.7%,89.2%±2.7% vs 79.1%±4.0%, all P< 0.05); in RSD group, the nocturnal AHI statistically decreased (27±14 vs 32±12, P< 0.05) with a significant increase in meanSpO2 (94.3%±2.2% vs 93.9%±2.0%, P< 0.05)while miniSpO2 showed no significant difference (80.1%±6.2% vs 79.5%±4.7%, P> 0.05). Compared with RSD group, there was a significantly lower AHI (P=0.000) but higher mean SpO2 and mini SpO2 (all P< 0.05) at Day 30 in CPAP group. At Day 30 in CPAP groups and RSD group, the mean systolic blood pressure (MSBp) were (130 ±12) and (122±9) mmHg (1 mmHg=0.133 kPa) respectively while the mean diastolic blood pressure (MDBp) (83±7) and (80±8) mmHg respectively. All these were significantly lower than those at pre-treatment with MSBp (136±14) mmHg and MDBp (87±7) mmHg in CPAP group and MSBp (134±20) mmHg and MDBp (88±14) mmHg in RSD group. The extent of decrease in MSBp post-treatment was more remarkable in RSD group than that in CPAP group (P< 0.05).Conclusions:In moderate-to-severe OSAS patients with hypertension, both CPAP and RSD may improve sleep respiratory parameters and blood pressure to varying degrees. There is a more significant improvement of nocturnal AHI and SpO2 in CPAP group and more lower MSBp in RSD group.