Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a systematic review and meta-analysis of six randomized controlled trials.

Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a systematic review and meta-analysis of six randomized controlled trials.

J Bras Pneumol. 2017 Jul 31;:0

Authors: Lei Q, Lv Y, Li K, Ma L, Du G, Xiang Y, Li X

Abstract
Objective:: To evaluate systematically the effects of continuous positive airway pressure (CPAP) on blood pressure in patients with resistant hypertension and obstructive sleep apnea (OSA).
Methods:: The Cochrane Library, PubMed, ScienceDirect, and the Web of Science were searched for studies investigating the effects of CPAP on blood pressure in patients with resistant hypertension and OSA. The selected studies underwent quality assessment and meta-analysis, as well as being tested for heterogeneity.
Results:: Six randomized controlled trials were included in the meta-analysis. The pooled estimates of the changes in mean systolic blood pressure and mean diastolic blood pressure (as assessed by 24-h ambulatory blood pressure monitoring) were -5.40 mmHg (95% CI: -9.17 to -1.64; p = 0.001; I2 = 74%) and -3.86 mmHg (95% CI: -6.41 to -1.30; p = 0.00001; I2 = 79%), respectively.
Conclusions:: CPAP therapy can significantly reduce blood pressure in patients with resistant hypertension and OSA.
Objetivo:: Avaliar sistematicamente os efeitos da continuous positive airway pressure (CPAP, pressão positiva contínua nas vias aéreas) na pressão arterial em pacientes com hipertensão resistente e apneia obstrutiva do sono (AOS).
M?todos:: Estudos que investigassem os efeitos da CPAP na pressão arterial em pacientes com hipertensão resistente e AOS foram buscados nos seguintes bancos de dados eletrônicos: Cochrane Library; PubMed; ScienceDirect e Web of Science. Os estudos selecionados foram submetidos a avaliação de qualidade, meta-análise e teste de heterogeneidade.
Resultados:: Foram incluídos na meta-análise seis ensaios clínicos controlados aleatórios. As estimativas combinadas das alterações das médias de pressão arterial sistólica e pressão arterial diastólica (medidas por meio de monitoração ambulatorial da pressão arterial durante 24 h) foram de -5,40 mmHg (IC95%: -9,17 a -1,64; p = 0,001; I2 = 74%) e -3,86 mmHg (IC95%: -6,41 a -1,30; p = 0,00001; I2 = 79%), respectivamente.
Conclus?es:: O tratamento com CPAP é capaz de reduzir significativamente a pressão arterial em pacientes com hipertensão resistente e AOS.

PMID: 28767770 [PubMed - as supplied by publisher]

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