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

IF 3.9 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Hypertension Reports Pub Date : 2024-05-01 Epub Date: 2024-03-09 DOI:10.1007/s11906-024-01294-4

Ling Sun, Ya-Fei Chang, Yun-Fei Wang, Quan-Xin Xie, Xian-Zhong Ran, Chun-Yang Hu, Bin Luo, Bin Ning

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引用次数: 0

Abstract

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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持续正压通气对耐药性高血压和阻塞性睡眠呼吸暂停患者血压的影响：最新 Meta 分析。

审查目的：持续气道正压（CPAP）对患有阻塞性睡眠呼吸暂停（OSA）的高危患者的抵抗性高血压的影响需要进一步研究。我们旨在确定 CPAP 对耐药性高血压和 OSA 患者血压的影响。我们检索了 PubMed、EMBASE、MEDLINE、Cochrane Library 和 CMB 等数据库。采用随机效应或固定效应模型对数据进行汇总，得出加权平均差（WMD）和 95% 置信区间（CI）：共纳入了 12 项试验和 718 名参与者。与对照组相比，CPAP 可明显降低 24 小时收缩压（SBP）（WMD：- 5.92 mmHg [ - 8.72, - 3.11]；P＜0.001）、24 小时舒张压（DBP）（WMD：- 4.44 mmHg [- 6.26 , - 2.62]；P＜0.001）、白天 SBP（WMD：- 5.76 mmHg [ - 9.16, - 2.36]；P＜0.001）、白天 DBP（WMD：- 3.92 mmHg [- 5.55, - 2.30]；夜间 SBP（WMD：- 4.87 mmHg [ - 7.96, - 1.78]；P = 0.002）和夜间 DBP（WMD：- 2.05 mmHg [- 2.99, - 1.11]；P＜0.001）。CPAP 可在短期（＜3 个月）和长期（≥3 个月）改善血压。对平均心率无明显影响（WMD：-2.76 次/分 [- 7.50, 1.97]；P = 0.25）。CPAP 治疗与抵抗性高血压和 OSA 患者的血压降低有关。

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来源期刊

Current Hypertension Reports 医学-外周血管病

CiteScore

10.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.