Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis

OBJECTIVE:To systematically analyze the studies that have examined the effect of continuous positive airway pressure (CPAP) on blood pressure (BP) in patients with resistant hypertension and obstructive sleep apnea (OSA). METHODS:Design – meta-analysis of observational studies and randomized control...

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Bibliographic Details
Published in:	Journal of hypertension Vol. 32; no. 12; pp. 2341 - 2350
Main Authors:	Iftikhar, Imran H, Valentine, Christopher W, Bittencourt, Lia R.A, Cohen, Debbie L, Fedson, Annette C, Gíslason, Thorarinn, Penzel, Thomas, Phillips, Craig L, Yu-sheng, Lin, Pack, Allan I, Magalang, Ulysses J
Format:	Journal Article
Language:	English
Published:	England Wolters Kluwer Health \| Lippincott Williams & Wilkins 01-12-2014
Subjects:	Aged Blood Pressure - physiology Continuous Positive Airway Pressure - adverse effects Female Humans Hypertension - physiopathology Male Middle Aged Sleep Apnea, Obstructive - epidemiology Sleep Apnea, Obstructive - therapy
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Summary:	OBJECTIVE:To systematically analyze the studies that have examined the effect of continuous positive airway pressure (CPAP) on blood pressure (BP) in patients with resistant hypertension and obstructive sleep apnea (OSA). METHODS:Design – meta-analysis of observational studies and randomized controlled trials (RCTs) indexed in PubMed and Ovid (All Journals@Ovid). participantsindividuals with resistant hypertension and OSA; interventions – CPAP treatment. RESULTS:A total of six studies met the inclusion criteria for preintervention to postintervention analyses. The pooled estimates of mean changes after CPAP treatment for the ambulatory (24-h) SBP and DBP from six studies were −7.21 mmHg [95% confidence interval (CI)−9.04 to −5.38; P < 0.001; I 58%) and −4.99 mmHg (95% CI−6.01 to −3.96; P < 0.001; I 31%), respectively. The pooled estimate of the ambulatory SBP and DBP from the four RCTs showed a mean net change of −6.74 mmHg [95% CI−9.98 to −3.49; P < 0.001; I 61%] and −5.94 mmHg (95% CI−9.40 to −2.47; P = 0.001; I 76%), respectively, in favor of the CPAP group. CONCLUSION:The pooled estimate shows a favorable reduction of BP with CPAP treatment in patients with resistant hypertension and OSA. The effects sizes are larger than those previously reported in patients with OSA without resistant hypertension.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0263-6352 1473-5598
DOI:	10.1097/HJH.0000000000000372