Theophylline therapy for cheyne-stokes respiration during sleep in a 41-year-old man with refractory arterial hypertension

Jacek Wolf, Ewa Świerblewska, Hanna Jasiel-Wojculewicz, Krzysztof Gockowski, Bogdan Wyrzykowski, Virend Somers, Krzysztof Narkiewicz

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2 Scopus citations

Abstract

We report a case of a 41-year-old man who was noted to have position-dependent Cheyne-Stokes respiration with central sleep apnea (CSA) during sleep. The patient had multiple cardiovascular risk factors and target organ damages, including a history of two myocardial infarctions, transient ischemic attack, and chronic kidney disease. His hypertension was refractory to a number of antihypertensive medicines, however, a complete elimination of sleep-disordered breathing with oral theophylline treatment was paralleled by a signifi cant BP fall with a subsequent need for reduction of antihypertensive drugs. Following these surprising observations we decided to withdraw theophylline from treatment (in-clinic). Theophylline discontinuation resulted in a gradual increase in BP and an urgent call for antihypertensive treatment modifi cation. These observations suggest a potent hypotensive action of oral theophylline via Cheyne- Stokes respiration with CSA elimination. Our data suggest that CSA may be a mechanism that raises BP even during the daytime.

Original languageEnglish (US)
JournalChest
Volume146
Issue number1
DOIs
StatePublished - 2014

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Wolf, J., Świerblewska, E., Jasiel-Wojculewicz, H., Gockowski, K., Wyrzykowski, B., Somers, V., & Narkiewicz, K. (2014). Theophylline therapy for cheyne-stokes respiration during sleep in a 41-year-old man with refractory arterial hypertension. Chest, 146(1). https://doi.org/10.1378/chest.13-2897