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Review
. 2015 Mar;17(3):215-22.
doi: 10.1111/jch.12472. Epub 2015 Jan 13.

The role of continuous positive airway pressure in blood pressure control for patients with obstructive sleep apnea and hypertension: a meta-analysis of randomized controlled trials

Xinyu Hu  1 , Jinqi Fan, Shaojie Chen, Yuehui Yin, Bernhard Zrenner
Affiliations
Review

The role of continuous positive airway pressure in blood pressure control for patients with obstructive sleep apnea and hypertension: a meta-analysis of randomized controlled trials

Xinyu Hu et al. J Clin Hypertens (Greenwich). 2015 Mar.

Abstract

The aim of this study was to review the effect of continuous positive airway pressure (CPAP) on blood pressure (BP) in patients with obstructive sleep apnea (OSA) and hypertension. Biomedical databases were searched for randomized controlled trials (RCTs) comparing CPAP with control among these patients. Seven RCTs reporting 24-hour ambulatory BP were identified for meta-analysis. CPAP was associated with significant reductions in 24-hour ambulatory systolic blood pressure (SBP) (-2.32 mm Hg; 95% confidence interval [CI], -3.65 to -1.00) and diastolic blood pressure (DBP) (-1.98 mm Hg; 95% CI, -2.82 to -1.14). CPAP led to more significant improvement in nocturnal SBP than that in diurnal SBP. Subgroup analysis showed that patients with resistant hypertension or receiving antihypertensive drugs benefited most from CPAP. Meta-regression indicated that CPAP compliance, age, and baseline SBP were positively correlated with decrease in 24-hour DBP, but not reduction in 24-hour SBP.

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Figures

Figure 1
Figure 1
Flowchart of selected and identified studies. OSA indicates obstructive sleep apnea; RCT indicates randomized controlled trial.
Figure 2
Figure 2
Forest plot for 24‐hour ambulatory systolic blood pressure (A) and diastolic blood pressure (B). CI indicates confidence interval; CPAP, continuous positive airway pressure.
Figure 3
Figure 3
Funnel plot for 24‐hour ambulatory systolic blood pressure (A), 24‐hour ambulatory diastolic blood pressure (B), nocturnal systolic blood pressure (C), nocturnal diastolic blood pressure (D), diurnal systolic blood pressure (E), and diurnal diastolic blood pressure (F).
See this image and copyright information in PMC

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