Effects of cilazapril on hypertension, sleep, and apnea

Epidemiologic studies revealed that up to 10 percent of middle-aged men show more than 10 cessations of breathing of more than 10 seconds' duration. In these patients, increased morbidity and mortality rates have been proved. More than 50 percent of apnea patients exhibit arterial hypertension, and up to 50 percent of hypertensive patients experience sleep apnea. Patients with sleep apnea and essential hypertension need special attention paid to their antihypertensive therapy because the following side effects of drugs have to be avoided: increases of cardiac insufficiency, hyperviscosity of the blood, intensification of the hypersomnia by central sedation, intensification of a pre-existing tendency towards arrhythmias, and deprivation of deep and rapid eye movement sleep. In this study, the effects of angiotensin-converting enzyme inhibitors in patients with sleep apnea and hypertension are examined. An interim evaluation of six patients (aged 50 to 57) yielded the following results: Average Broca index, 124; average blood pressure before therapy, 159/102 mm Hg; average blood pressure after therapy, 132/78; a decrease of the apnea and hypopnea index from x = 31 (range, 12 to 77) to x = 20 (range, two to 54). Therapy did not influence sleep structure: before therapy, an average of 19 percent of sleep episodes were of the rapid eye movement type (range, 11 to 32 percent); after therapy, 23 percent were of this type on average (range, 21 to 25 percent). A final evaluation will be carried out after the second study phase for 12 patients who have been treated in a double-blind scheme with metropolol versus cilazapril.
Sleep apnea is a condition in which breathing stops for longer than 10 seconds during sleep. Up to 10 percent of middle-aged men experience sleep apnea. These people have increased rates of death and disease. More than 50 percent of patients with apnea have hypertension, or abnormally high blood pressure; similarly, up to 50 percent of patients with hypertension have sleep apnea. The relation between sleep apnea and hypertension is of particular importance because antihypertensive drugs increase cardiac insufficiency or impair cardiac function, increase the viscosity or stickiness of the blood, cause sedation, increase the risk of arrhythmias or abnormal heart rhythms, and prevent deep and rapid eye movement sleep. The effects of angiotensin-converting enzyme inhibitors used to treat hypertension were examined in six patients with sleep apnea and hypertension. These antihypertensive agents decreased both blood pressure and sleep apnea, and did not affect sleep structure or the type of sleep experienced, such as the rapid eye movement type. A final evaluation of the effects of angiotensin-converting enzyme inhibitors on sleep apnea will be carried out in an additional 12 patients. (Consumer Summary produced by Reliance Medical Information, Inc.)