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J Clin Sleep Med. 2014 Apr 15;10(4):365-9. doi: 10.5664/jcsm.3604.

Blood pressure improvement with continuous positive airway pressure is independent of obstructive sleep apnea severity.

Author information

1
Division of Sleep Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston MA.
2
Division of Translational Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston MA.
3
Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston MA.
4
Research Department, Sleep Division, Araba University, Basque Country University, Vitoria Spain.
5
Hospital Arnau de Vilanova, IRB Lleida, Respiratory Department, Lleida, Spain. CIBERes, Madrid, Spain.
6
Division of Sleep Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston MA ; Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston MA.

Erratum in

  • J Clin Sleep Med. 2014;10(6):711. Barandiarán, Felipe Aizpuru [corrected to Aizpuru, Felipe].

Abstract

STUDY OBJECTIVES:

We sought to perform a patient-level meta-analysis using the individual patient data of the trials identified in our previous study-level meta-analysis investigating the effect of positive airway pressure (PAP) treatment for obstructive sleep apnea (OSA) on blood pressure (BP).

DESIGN:

Patient-level meta-analysis.

SETTING:

N/A.

PARTICIPANTS:

968 adult OSA subjects without major comorbidities drawn from eight randomized controlled trials.

INTERVENTIONS:

Therapeutic PAP versus non-therapeutic control conditions (sham-PAP, pill placebo or standard care) over at least one week.

MEASUREMENTS AND RESULTS:

The mean reductions in BP between PAP and non-therapeutic control arms were -2.27 mm Hg (95% CI -4.01 to -0.54) for systolic BP and -1.78 mm Hg (95% CI -2.99 to -0.58) for diastolic BP. The presence of uncontrolled hypertension at baseline was significantly associated with a reduction in systolic BP of 7.1 mm Hg and diastolic BP of 4.3 mm Hg after controlling for OSA severity (apnea-hypopnea index, Epworth Sleepiness Scale score, PAP level), patient demographics (age, gender, body mass index, use of antihypertensive medication/s), and measures of PAP efficacy (PAP adherence and treatment duration).

CONCLUSIONS:

OSA patients with uncontrolled hypertension are likely to gain the largest benefit from PAP in terms of a substantial reduction in BP, even after controlling for disease severity.

KEYWORDS:

Patient-level meta-analysis; hypertension; lung; obstructive sleep apnea; positive airway pressure

PMID:
24733980
PMCID:
PMC3960377
DOI:
10.5664/jcsm.3604
[Indexed for MEDLINE]
Free PMC Article

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