Background One of the most common secondary causes of hypertension is obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is used to treat OSA.
Objective To evaluate the effects of CPAP on blood pressure among those with OSA in randomized controlled trials.
Data Sources Studies were retrieved by searching MEDLINE (1996-July 2006) using the Medical Subject Headings continuous positive airway pressure, positive-pressure respiration, sleep apnea syndromes, sleep apneaobstructive, polysomnography,sleep stages,randomized controlled trial, and controlled clinical trial. Bibliographies of all retrieved articles were also searched.
Study Selection From 255 relevant retrieved reports, 16 randomized clinical trials compared CPAP with control among participants with OSA, a minimum treatment duration of 2 weeks, and reported blood pressure as an end point.
Data Extraction Data on baseline characteristics of trials and participants including study design, participant distribution according to age, sex, baseline blood pressure, comorbidities, severity of OSA, measurement of outcome, and analysis methods were independently abstracted by two investigators using a standardized protocol.
Data Synthesis Data from 16 trials representing 818 participants was examined using a random-effects model. The mean difference for overall systolic blood pressure for those treated with CPAP compared with control was −2.67 mm Hg (95% confidence interval [CI], −4.78 to −0.57). For overall diastolic blood pressure, the mean difference was −2.07 mm Hg (95% CI −3.44 to −0.70).
Conclusions These results indicate that CPAP use decreases blood pressure among those with OSA and may help prevent hypertension.
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