Effect of CPAP therapy on cardiovascular events and mortality in patients with obstructive sleep apnea: a meta-analysis

Guo, Jun; Sun, Yu; Xue, Lijun; Huang, Ziyang; Wang, Yong-Shen; Zhang, Lei; Zhou, Guihua; Li, Yuan

doi:10.1007/s11325-016-1319-y

Cited by 67 publications

(48 citation statements)

References 34 publications

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“…However, our meta-analysis revealed no significant treatment effect of CPAP on cardiovascular events in nonsleepy OSA patients. A recently published meta-analysis about the effect of CPAP therapy on cardiovascular events (38) had a similar finding that CPAP could not decrease the risk of cardiovascular events compared with the control group (OR, 0.84; 95% CI, 0.62-1.13; P=0.25). Considering the limited number of people included and the short duration of follow- up, the negative results in our meta-analysis could not exclude the possibility that non-sleepy OSA patients could benefit from long-term CPAP use.…”

Section: Discussionmentioning

confidence: 79%

Continuous positive airway pressure therapy in non-sleepy patients with obstructive sleep apnea: results of a meta-analysis

et al. 2016

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Section: Discussionmentioning

confidence: 79%

Continuous positive airway pressure therapy in non-sleepy patients with obstructive sleep apnea: results of a meta-analysis

et al. 2016

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“…The analysis indicated that the severity of OSA was associated with a stronger impact of CPAP on systolic BP (47). The beneficial effect of CPAP on BP and the effect size were confirmed by successive meta-analyses (73,74). Patients with severe OSA or treatment-resistant hypertension were reported to have the most clinically relevant effects.…”

Section: Osamentioning

confidence: 89%

Cardiorespiratory interaction with continuous positive airway pressure

Pengo¹,

Bonafini²,

Fava³

et al. 2018

J. Thorac. Dis.

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The treatment of choice for obstructive sleep apnoea (OSA) is continuous positive airway pressure therapy (CPAP). Since its introduction in clinical practice, CPAP has been used in various clinical conditions with variable and heterogeneous outcomes. In addition to the well-known effects on the upper airway CPAP impacts on intrathoracic pressures, haemodynamics and blood pressure (BP) control. However, short- and long-term effects of CPAP therapy depend on multiple variables which include symptoms, underlying condition, pressure used, treatment acceptance, compliance and usage. CPAP can alter long-term cardiovascular risk in patients with cardiorespiratory conditions. Furthermore, the effect of CPAP on the awake patient differs from the effect on the patients while asleep, and this might contribute to discomfort and removal of the use interface. The purpose of this review is to highlight the physiological impact of CPAP on the cardiorespiratory system, including short-term benefits and long-term outcomes.

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“…Continuous positive airway pressure (CPAP) therapy can lower the risk of HTN (115). However, due in part to low long-term adherence to CPAP therapy, meta-analyses indicate that CPAP therapy for OSA results in only small (1–2 mmHg) average reductions in BP (116–118) - levels not sufficient to bring HTN under control nor large enough to reduce risk of stroke or coronary heart disease (119). Treatment with antihypertensive drugs yields larger long-lasting reductions in BP in populations with OSA who do not use CPAP (120–122), but, these drugs fail to generate the reductions obtained in HTN patients without OSA (123).…”

Section: Resultsmentioning

confidence: 99%

Chronotherapy for Hypertension

et al. 2018

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Given the emerging knowledge that circadian rhythmicity exists in every cell and all organ systems, there is increasing interest in the possible benefits of chronotherapy for many diseases. There is a well-documented 24-h pattern of blood pressure with a morning surge that may contribute to the observed morning increase in adverse cardiovascular events. Historically, antihypertensive therapy involves morning doses, usually aimed at reducing daytime blood pressure surges, but an absence of nocturnal dipping blood pressure is also associated with increased cardiovascular risk. To more effectively reduce nocturnal blood pressure and still counteract the morning surge in blood pressure, a number of studies have examined moving one or more antihypertensives from morning to bedtime dosing. More recently, such studies of chronotherapy have studied comorbid populations including obstructive sleep apnea, chronic kidney disease, or diabetes. Here, we summarize major findings from recent research in this area (2013-2017). In general, nighttime administration of antihypertensives improved overall 24-h blood pressure profiles regardless of disease comorbidity. However, inconsistencies between studies suggest a need for more prospective randomized controlled trials with sufficient statistical power. In addition, experimental studies to ascertain mechanisms by which chronotherapy is beneficial could aid drug design and guidelines for timed administration.

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Effect of CPAP therapy on cardiovascular events and mortality in patients with obstructive sleep apnea: a meta-analysis

Abstract: CPAP therapy was associated with a trend of decreased risk of cardiovascular events. Furthermore, ESS and BP were significantly lower in the CPAP group. Larger randomized studies are needed to confirm these findings.

Cited by 67 publications

References 34 publications

Continuous positive airway pressure therapy in non-sleepy patients with obstructive sleep apnea: results of a meta-analysis

Continuous positive airway pressure therapy in non-sleepy patients with obstructive sleep apnea: results of a meta-analysis

Cardiorespiratory interaction with continuous positive airway pressure

Chronotherapy for Hypertension

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