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Obstructive sleep apnoea treatment and blood pressure: Which phenotypes predict a response? A systematic review and meta-analysis
- Publication Year :
- 2020
- Publisher :
- European Respiratory Society, 2020.
-
Abstract
- The treatment for obstructive sleep apnoea (OSA) with continuous positive airway pressure (CPAP) or mandibular advancement devices (MADs) is associated with blood pressure (BP) reduction; however, the overall effect is modest. The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effect of such treatments on BP was to identify subgroups of patients who respond best to treatment.The article search was performed in three different databases with specific search terms and selection criteria. From 2289 articles, we included 68 RCTs that compared CPAP or MADs with either passive or active treatment. When all the studies were pooled together, CPAP and MADs were associated with a mean BP reduction of −2.09 (95% CI −2.78– −1.40) mmHg for systolic BP and −1.92 (95% CI −2.40– −1.43) mmHg for diastolic BP and −1.27 (95% CI −2.34– −0.20) mmHg for systolic BP and −1.11 (95% CI −1.82– −0.41) mmHg for diastolic BP, respectively. The subgroups of patients who showed a greater response were those aged Although this meta-analysis shows that the expected reduction of BP by CPAP/MADs is modest, it identifies specific characteristics that may predict a pronounced benefit from CPAP in terms of BP control. These findings should be interpreted with caution; however, they are particularly important in identifying potential phenotypes associated with BP reduction in patients treated for OSA.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
continuous positive airway pressure (CPAP)
OSA, CPAP
medicine.medical_treatment
Diastole
Blood Pressure
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
In patient
Continuous positive airway pressure
obstructive sleep apnea
Randomized Controlled Trials as Topic
Sleep Apnea, Obstructive
Continuous Positive Airway Pressure
business.industry
medicine.disease
meta-analysis
Obstructive sleep apnea
Phenotype
Blood pressure
Search terms
030228 respiratory system
Meta-analysis
Cardiology
Active treatment
business
Mandibular Advancement
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....b508f316ca29509e7984a3a08236a20a