Effect of Continuous Positive Airway Pressure on Blood Pressure in Patients with Resistant Hypertension and Obstructive Sleep Apnea: An Updated Meta-analysis

Mar 9, 2024Current hypertension reports

Continuous Positive Airway Pressure’s effect on blood pressure in patients with hard-to-treat high blood pressure and obstructive sleep apnea

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Abstract

CPAP significantly reduced 24-hour systolic blood pressure by 5.92 mmHg in patients with resistant hypertension and obstructive sleep apnea.

CPAP also decreased 24-hour diastolic blood pressure by 4.44 mmHg.
Daytime systolic and diastolic blood pressure were reduced by 5.76 mmHg and 3.92 mmHg, respectively.
Nighttime systolic and diastolic blood pressure reductions were 4.87 mmHg and 2.05 mmHg, respectively.
Improvements in blood pressure were observed in both the short term (less than 3 months) and long term (3 months or more).
No significant change in mean heart rate was found.

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PURPOSE OF REVIEW: The effect of continuous positive airway pressure (CPAP) on resistant hypertension in patients at high risk with obstructive sleep apnea (OSA) needs further investigation. We aimed to determine the effect of CPAP on blood pressure in patients with resistant hypertension and OSA. Databases including PubMed, EMBASE, MEDLINE, the Cochrane Library, and CMB were searched. Data were pooled using a random-effects or fixed-effects model to derive weighted mean differences (WMDs) and 95% confidence intervals (CIs).

RECENT FINDINGS: A total of 12 trials and 718 participants were included. Compared with control, CPAP significantly reduced 24-h systolic blood pressure (SBP) (WMD: - 5.92 mmHg [ - 8.72, - 3.11]; P＜0.001), 24-h diastolic blood pressure (DBP) (WMD: - 4.44 mmHg [- 6.26 , - 2.62]; P ＜0.001), daytime SBP (WMD: - 5.76 mmHg [ - 9.16, - 2.36]; P ＜0.001), daytime DBP (WMD: - 3.92 mmHg [- 5.55, - 2.30]; nighttime SBP (WMD: - 4.87 mmHg [ - 7.96 , - 1.78]; P = 0.002), and nighttime DBP (WMD: - 2.05 mmHg [- 2.99, - 1.11]; P＜0.001) in patients with resistant hypertension and OSA. CPAP improved the blood pressure both in the short (＜3 months) and long term (≥ 3 months). No significant impact on mean heart rate was noted (WMD: -2.76 beats per min [- 7.50, 1.97]; P = 0.25). CPAP treatment was associated with BP reduction in patients with resistant hypertension and OSA.

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Effect of Continuous Positive Airway Pressure on Blood Pressure in Patients with Resistant Hypertension and Obstructive Sleep Apnea: An Updated Meta-analysis

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