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Meta-Analysis
. 2018 Jun;8(1):010405.
doi: 10.7189/jogh.08.010405.

Association of obstructive sleep apnea with hypertension: A systematic review and meta-analysis

Haifeng Hou  1   2   3 , Yange Zhao  4   3 , Wenqing Yu  4   3 , Hualei Dong  5 , Xiaotong Xue  5 , Jian Ding  5 , Weijia Xing  1   3 , Wei Wang  1   2   3
Affiliations
Meta-Analysis

Association of obstructive sleep apnea with hypertension: A systematic review and meta-analysis

Haifeng Hou et al. J Glob Health. 2018 Jun.

Abstract

Background: Obstructive sleep apnea (OSA) is a sleep disorder characterized as complete or partial upper airflow cessation during sleep. Although it has been widely accepted that OSA is a risk factor for the development of hypertension, the studies focusing on this topic revealed inconsistent results. We aimed to clarify the association between OSA and hypertension, including essential and medication-resistant hypertension.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. PubMed and Embase databases were used for searching the relevant studies published up to December 31, 2016. A quantitative approach of meta-analysis was performed to estimate the pooled odds ratio (OR) and 95% confidence interval (CI).

Results: Twenty-six studies with 51 623 participants (28 314 men, 23 309 women; mean age 51.8 years) met inclusion criteria and were included in this study. Among them, six studies showed a significant association between OSA and resistant hypertension (pooled OR = 2.842, 95% CI = 1.703-3.980, P < 0.05). Meanwhile, the combination of 20 original studies on the association of OSA with essential hypertension also presented significant results with the pooled ORs of 1.184 (95% CI = 1.093-1.274, P < 0.05) for mild OSA, 1.316 (95% CI = 1.197-1.433, P < 0.05) for moderate OSA and 1.561 (95% CI = 1.287-1.835, P < 0.05) for severe OSA.

Conclusions: Our findings indicated that OSA is related to an increased risk of resistant hypertension. Mild, moderate and severe OSA are associated essential hypertension, as well a dose-response manner relationship is manifested. The associations are relatively stronger among Caucasians and male OSA patients.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf (available upon request from the corresponding author) and declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the study selection.
Figure 2
Figure 2
Forest plot of the association between resistant hypertension and obstructive sleep apnea (OSA).
Figure 3
Figure 3
Forest plots of the association between essential hypertension and mild obstructive sleep apnea (OSA).
Figure 4
Figure 4
Forest plots of the association between essential hypertension and moderate obstructive sleep apnea (OSA).
Figure 5
Figure 5
Forest plots of the association between essential hypertension and severe obstructive sleep apnea OSA).
See this image and copyright information in PMC

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