American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jan 2019
Randomized Controlled TrialEffect of Supplemental Oxygen on Blood Pressure in Obstructive Sleep Apnea (SOX): A Randomised, CPAP Withdrawal Trial.
Obstructive sleep apnea (OSA) is associated with systemic hypertension. Either overnight intermittent hypoxia, or the recurrent arousals that occur in OSA, could cause the daytime increases in blood pressure (BP). ⋯ Supplemental oxygen virtually abolished the rise in morning BP during CPAP withdrawal. Supplemental oxygen substantially reduced intermittent hypoxia, but had a minimal effect on markers of arousal (including AHI), subjective sleepiness, or objective sleepiness. Therefore intermittent hypoxia, and not recurrent arousals, appears to be the dominant cause of daytime increases in BP in OSA.
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Am. J. Respir. Crit. Care Med. · Jan 2019
Randomized Controlled TrialCapturing Exacerbations of Chronic Obstructive Pulmonary Disease with EXACT: A Sub-Analysis of FLAME.
Chronic obstructive pulmonary disease exacerbations accelerate lung function decline, reduce quality of life, and increase mortality. A subset of patients (n = 457) from the FLAME (Effect of Indacaterol Glycopyrronium vs. Fluticasone Salmeterol on COPD Exacerbations) study used the Exacerbations of COPD Tool (EXACT) to capture symptom-defined exacerbations. ⋯ Regardless of the exacerbation definition used, our findings support the use of long-acting β2 agonists/long-acting muscarinic receptor antagonists as the preferred treatment option for patients at risk of future exacerbations. Clinical trial registered with www.clinicaltrials.gov (NCT01782326).