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Arch Pediatr Adolesc Med. 2007 Feb;161(2):172-8.

Sleep-disordered breathing and blood pressure in children: a meta-analysis.

Author information

1
Department of Biomathematics, University of Thessaly School of Medicine, Larissa, Greece. zintza@med.uth.gr

Abstract

OBJECTIVES:

To estimate the risk of elevated blood pressure (BP) in children with obstructive sleep-disordered breathing (SDB) and to explore heterogeneity among published studies.

DATA SOURCE:

PubMed database.

STUDY SELECTION:

Pediatric cohort studies that investigated the relationship between SDB and BP.

MAIN EXPOSURE:

Level of severity of SDB.

MAIN OUTCOME MEASURES:

Elevated systolic and diastolic BP.

RESULTS:

During wakefulness, moderate to severe SDB was associated with 87% and 121% higher risk for elevated systolic and diastolic BP, respectively, compared with mild or no SDB, but the association was not statistically significant (random-effects odds ratio [OR], 1.87; 95% confidence interval [CI], 0.73-4.80; and random-effects OR, 2.21; 95% CI, 0.80-6.10, respectively). In terms of heterogeneity, reports of systolic BP were characterized by large heterogeneity (quantification heterogeneity metric [I(2)] = 53%), whereas studies recording diastolic BP had moderate heterogeneity (I(2) = 31%). During sleep, large heterogeneity was identified among studies regarding elevated systolic BP (I(2) = 54%), and the random-effects OR was 1.20 (95% CI, 0.29-5.02). No heterogeneity was detected regarding elevated diastolic BP (I(2) = 0%), although the fixed-effects OR was still not statistically significant (OR, 2.23; 95% CI, 0.61-8.16).

CONCLUSIONS:

No evidence exists that moderate to severe SDB in childhood increases the risk of elevated BP, and there is heterogeneity among published reports. Large and methodologically rigorous investigations are needed.

PMID:
17283303
DOI:
10.1001/archpedi.161.2.172
[Indexed for MEDLINE]
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