Effect of Continuous Positive Airway Pressure on Ambulatory BP in Patients With Sleep Apnea and Hypertension

Campos‐Rodríguez, Francisco; Reina, A; Pérez-Ronchel, José; Merino-Sanchez, Mercedes; González-Benítez, M.A.; Beltrán-Robles, Manuel; González, C. Almeida

doi:10.1378/chest.129.6.1459

Cited by 169 publications

(112 citation statements)

References 35 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…158 A randomized placebo-controlled study of 1 month of therapeutic CPAP versus subtherapeutic CPAP on ambulatory BP showed no significant changes in systolic, diastolic, daytime, or nighttime BP. 159 Finally, 3 meta-analyses of the effect of treating OSA with CPAP on BP have been published recently. One was restricted to trials involving ambulatory BP recordings, 160 the other to trials with treatment duration of Ͼ2 weeks.…”

Section: Treatment Of Osa: Effects On Hypertensionmentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

View full text Add to dashboard Cite

Section: Treatment Of Osa: Effects On Hypertensionmentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

View full text Add to dashboard Cite

“…28,31 We included a total of 16 trials representing data from 818 participants. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] …”

Section: Study Selectionmentioning

confidence: 99%

Effect of Nocturnal Nasal Continuous Positive Airway Pressure on Blood Pressure in Obstructive Sleep Apnea

et al. 2007

View full text Add to dashboard Cite

Abstract-Obstructive sleep apnea (OSA) is a very common risk factor for hypertension, and continuous positive airway pressure (CPAP) has been widely used to treat OSA. We conducted a meta-analysis of randomized, controlled trials to evaluate the effects of CPAP on blood pressure, reported as either a primary or secondary end point, among patients with OSA. Studies were retrieved by searching Medline (January 1980 to July 2006), the Cochrane Database of Systematic Reviews, conference abstracts, and bibliographies of review and original articles. From 255 relevant reports, 16 randomized clinical trials were selected that compared CPAP to control among participants with OSA, had a minimum treatment duration of 2 weeks, and reported blood pressure changes during the intervention or control period. Data on sample size, participant characteristics, study design, intervention methods, duration, and treatment results were independently abstracted by 2 investigators using a standardized protocol. Data from 16 trials representing 818 participants were examined using a random-effects model. Key Words: continuous positive airway pressure Ⅲ meta-analysis Ⅲ randomized, controlled trial Ⅲ sleep apnea syndromes Ⅲ blood pressure H ypertension is an important public health challenge worldwide. Its high prevalence and subsequent increased risk for developing cardiovascular diseases including heart attack, stroke, and chronic kidney disease have placed it as the leading risk factor for all-cause mortality and a major cause of life years-adjusted disability. 1 A recent study on the global burden of hypertension found that 26.4% of the adult population in 2000 had hypertension, and 29.2% were projected to have hypertension by the year 2025. This translates to Ϸ972 million persons, 333 million in economically developed countries and 639 million in economically developing countries, with hypertension in 2000. In 2025, 1.56 billion adults are expected to have hypertension. 2 Obstructive sleep apnea (OSA) is a very common risk factor for hypertension. In 2003, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure recognized sleep apnea as a common and identifiable cause of hypertension and suggested blood pressure (BP) screening among patients with OSA. 3 Although the prevalence varies by population and age group, it has been estimated that OSA affects Ϸ24% of middle aged men and 9% of middle-aged women. 4 In addition, the 5-year incidence was recently estimated to be 16% for mild-to-moderate and 7.5% for severe forms of OSA in the adult population. 5 Given the prevalence of OSA and its deleterious consequences, randomized, controlled trials have evaluated the use of continuous positive airway pressure (CPAP) to reduce BP among persons with OSA. Unfortunately, many of these trials were small in sample size and did not have sufficient statistical power to detect a modest but potentially important reduction in BP. We conducted a meta-analysis of randomized, controlled t...

show abstract

“…28 Previous clinical trials of the effects of CPAP on BP in patients with OSA [41][42][43][44][45][46][47][48][49][50][51][52] have given inconsistent results, perhaps because of the study design, different sample size, and comorbid conditions. Bazzano et al 53 evaluated 16 randomized trials and found a pooled mean net change of -2.46 mmHg in systolic BP, -1.83 mmHg in diastolic BP, and -2.22 mmHg in MAP in those using CPAP therapy compared with control groups.…”

Section: Hypertensionmentioning

confidence: 99%