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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
Open accessAbstract
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.
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“Although several SRs and meta-analyses have noted reductions in BP with CPAP treatment of OSA, particularly moderate to severe OSA, caution is warranted because of heterogeneity in the pooled studies.39,654,1207–1211”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [1210]
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“These meta-analyses have shown a significant decrease in nighttime BP as well as a long-term (12 weeks) reduction in mean and diastolic BP with CPAP device usage of 4 or more hours a night.39,1210,1211”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [1210]
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“Meta-analyses have indicated a greater magnitude of BP reduction with CPAP therapy, in the range of 5–7 mmHg in systolic BP and 3–5 mmHg in diastolic BP, in those with resistant HTN.1210,1211”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [1210]
In the citing paper
“Modest reduction in mean systolic blood pressure (SBP) (−4.92 mm Hg; 95%CI −8.70 to −1.14) and mean (−2.56 mm Hg; 95% CI −4.43 to −0.68 mmHg) nighttime blood pressure were seen. No significant change in daytime SBP (−0.74 mm Hg; 95% CI −3.9 to 2.41) and daytime diastolic blood pressure (−1.86 mm Hg; 95% CI −4.55 to 0.83) were observed, however.(115)”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [115]
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Metadata
- Authors
- Iftikhar, I. H., Valentine, C. W., Bittencourt, L. R. A., Cohen, D. L., Fedson, A. C., Gíslason, T., Penzel, T., Phillips, C. L., Yu-sheng, L., Pack, A. I., & Magalang, U. J.
- Affiliations
- The University of Sydney (AU)
- The Ohio State University Wexner Medical Center (US)
- Universidade Federal de São Paulo (BR)
- University of Pennsylvania (US)
- Charité – Universitätsmedizin Berlin (DE)
- Taoyuan Chang Gung Memorial Hospital (TW)
- Corresponding author
- Magalang, Ulysses J.
- ORCID
- Venue
- Journal of Hypertension
- Published
- 2014-12
- Volume
- 32
- Issue
- 12
- Pages
- 2341-2350
- ISSN
- 0263-6352 (ISSN-L)
- PMC
- PMC4291165
- OpenAlex
- W2095580030
- Semantic Scholar
- 97d6f03d465a5ab46865d44e6004b532716eb7e3
- Cited by
- 215
- References
- 49
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 16 · 2023: 13 · 2022: 18 · 2021: 19 · 2020: 18 · 2019: 29 · 2018: 31 · 2017: 15 · 2016: 18 · 2015: 17 · 2014: 1
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- Funders
- Ohio State University
- National Institutes of Health (UL1TR001070, UL1TR000090)
- Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston
- National Heart, Lung, and Blood Institute (HL-093463, P01HL094307, R01HL093463)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- continuous positive airway pressure, resistant hypertension, obstructive sleep apnea, blood pressure reduction, ambulatory blood pressure
- MeSH terms
- Aged, Blood Pressure, Female, Humans, Hypertension, Male, Middle Aged, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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