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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; 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.
J Hypertens ; 32(12): 2341-50; discussion 2350, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25243523

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.