Clinical Methods and PathophysiologyAssessment of hypertension in obstructive sleep apnea by ambulatory blood pressure monitoring: a systematic review and meta-analysisYildiz, Abdullah Buraka; Siriopol, Dimitrieb,c; Vehbi, Sezana; Özgü, Özdea; Yağ, Buraka; Kanbay, Asiyed; Kanbay, Mehmete Author Information aDepartment of Medicine, Koc University School of Medicine, Istanbul, Turkey bDepartment of Nephrology, ‘Saint John the New’ County Hospital cDepartment of Internal Medicine, ‘Stefan cel Mare’ University, Suceava, Romania dDepartment of Pulmonary Medicine, Medicana Atasehir Hospital eDepartment of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey Received 8 February 2022 Accepted 24 April 2022 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.bpmonitoring.com. Correspondence to Mehmet Kanbay, MD, Division of Nephrology, Department of Medicine, Koc University School of Medicine, 34010, Istanbul, Turkey, Tel: +90 212 2508250; fax: +90 850 2508250, e-mail: [email protected] Blood Pressure Monitoring: October 2022 - Volume 27 - Issue 5 - p 285-296 doi: 10.1097/MBP.0000000000000613 Buy SDC Metrics Abstract Among obstructive sleep apnea (OSA) patients, there exists a high prevalence of hypertension. Determining the optimal blood pressure (BP) monitoring modality in this population will lead to a better understanding of hypertension profiles and a more accurate diagnosis of hypertension. PubMed, Ovid/Medline, Web of Science, Scopus, Cochrane Library, and CINAHL databases were screened, and the relevant articles regarding BP monitoring in OSA patient population were selected. Studies evaluating both ambulatory (ABPM) and office BP measurements were selected to be analyzed for the hypertension diagnosis specificity of ABPM measurement in OSA patients compared with office measurements. If reported, additional information regarding white-coat, masked hypertension, and circadian BP pattern prevalence was included. A cumulative analysis of five studies revealed a prevalence of hypertension based on BP to be 44%, whereas a cumulative analysis of four studies revealed a prevalence of hypertension based on ABPM to be 66%. Excluding a study with the nighttime assessment of hypertension reduced the cumulative prevalence of hypertension in OSA patients to 59%. The cumulative prevalence of Studies demonstrated the prevalence of masked and white-coat hypertension to be 34 and 9%, respectively. As a higher prevalence of hypertension was detected by ABPM and nighttime measurement, it can be deduced that ABPM is more sensitive in determining OSA patients with hypertension, and that nighttime ABPM further increases this sensitivity. The presence of masked and white-coat hypertension in OSA patients underlines the importance of correct hypertension diagnosis as it affects further management in this population with increased cardiovascular risk. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.