Impact of Cpap on Blood Pressure in Obstructive Sleep Apnoea

A systematic review 1 including 12 RCTs with a total of 572 subjects was abstracted in DARE. The pooled estimate of the effect of the continuous positive airway pressure (CPAP) intervention was a net decrease of 1.69 mm Hg in 24-hour ambulatory mean blood pressure (95% CI -2.69 to -0.69; random-effects model; moderate statistical heterogeneity, I² = 41%). Predefined metaregression analyses estimated that 24-hour MBP would decrease by 0.89 mm Hg per 10-point increase in apnea-hypopnea index at entry (P = 0.006), by 0.74 mm Hg for each increase of 10 arousal events per hour slept (P = 0.008), and by 1.39 mm Hg for each 1-hour increase in effective nightly use of the CPAP device (P = 0.01).

Another systematic review 2 including 16 RCTs (9 parallel-group, 7 crossover) with a total of 818 subjects was abstracted in DARE. CPAP was associated with a clinically significant reduction in the mean net change in systolic blood pressure (-2.46 mmHg, 95% CI -4.30 to -0.62), diastolic blood pressure (-1.83 mmHg, 95% CI -3.05 to -0.61) and mean arterial pressure (-2.22 mmHg, 95% CI -4.38 to -0.05) compared with control. There was no significant difference between daytime and night-time BP measurements.

References

• Haentjens P, Van Meerhaeghe A, Moscariello A, De Weerdt S, Poppe K, Dupont A, Velkeniers B. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007 Apr 23;167(8):757-64. [PubMed] [DARE]
• Bazzano LA, Khan Z, Reynolds K, He J. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension 2007 Aug;50(2):417-23. [PubMed] [DARE]