CPAP treatment significantly reduced ambulatory 24-hour systolic blood pressure by a mean net change of -6.74 mmHg (95% CI -9.98 to -3.49; P<0.001) in patients with resistant hypertension and OSA.
Meta-Analysis
Estimación del efecto: Mean net change -6.74 mmHg (95% CI -9.98 to -3.49)
valor p: p=<0.001
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.
Iftikhar et al. (Sat,) conducted a meta-analysis in Resistant hypertension and obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) was evaluated on Ambulatory (24-h) systolic blood pressure (SBP) (Mean net change -6.74 mmHg, 95% CI -9.98 to -3.49, p=<0.001). CPAP treatment significantly reduced ambulatory 24-hour systolic blood pressure by a mean net change of -6.74 mmHg (95% CI -9.98 to -3.49; P<0.001) in patients with resistant hypertension and OSA.