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

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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
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Issue Date
2014-12

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Citation
J. Hypertens. 2014, 32 (12):2341-50; discussion 2350
Abstract
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).
Design - meta-analysis of observational studies and randomized controlled trials (RCTs) indexed in PubMed and Ovid (All Journals@Ovid). participants: individuals with resistant hypertension and OSA; interventions - CPAP treatment.
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; I² 58%) and -4.99 mmHg (95% CI: -6.01 to -3.96; P < 0.001; I² 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; I² 61%] and -5.94 mmHg (95% CI: -9.40 to -2.47; P = 0.001; I² 76%), respectively, in favor of the CPAP group.
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.
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http://dx.doi.org/ 10.1097/HJH.0000000000000372
http://ovidsp.uk.ovid.com/sp-3.15.1b/ovidweb.cgi?WebLinkFrameset=1&S=AAKHPDHKGPHFILPLFNKKBAAGONACAA00&returnUrl=ovidweb.cgi%3f%26Full%2bText%3dL%257cS.sh.22.23%257c0%257c00004872-201412000-00007%26S%3dAAKHPDHKGPHFILPLFNKKBAAGONACAA00&directlink=http%3a%2f%2fgraphics.uk.ovid.com%2fovftpdfs%2fPDHFFNAGBAPLGP00%2ffs046%2fovft%2flive%2fgv023%2f00004872%2f00004872-201412000-00007.pdf&filename=Effects+of+continuous+positive+airway+pressure+on+blood+pressure+in+patients+with+resistant+hypertension+and+obstructive+sleep+apnea%3a++a+meta-analysis.&pdf_key=PDHFFNAGBAPLGP00&pdf_index=/fs046/ovft/live/gv023/00004872/00004872-201412000-00007
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Archived with thanks to Journal of hypertension
ae974a485f413a2113503eed53cd6c53
10.1097/HJH.0000000000000372
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