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

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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

Iftikhar, Imran H.a; Valentine, Christopher W.b; Bittencourt, Lia R.A.c; Cohen, Debbie L.d; Fedson, Annette C.e; Gíslason, Thorarinnf; Penzel, Thomasg; Phillips, Craig L.h,i; Yu-sheng, Linj; Pack, Allan I.e; Magalang, Ulysses J.k

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Journal of Hypertension 32(12):p 2341-2350, December 2014. | DOI: 10.1097/HJH.0000000000000372

Abstract

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). participants: individuals 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; 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.

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.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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