Sleep Apnea: Effect of CPAP on Blood Pressure

MedicalResearch.com Interview with:
Cristiano Fava MD, PhD
University of Verona
Department of Medicine
Division of Internal Medicine C
Hospital “Policlinico G.B. Rossi”
37134 Verona Italy

University of Lund
Department of Clinical Sciences
Division of Endocrinology
CRC, Lund University
S-205 02 Malmö Sweden

MedicalResearch.com: What are the main findings of the study?

Dr. Fava: The main finding of the meta-analysis is that cPAP usage for at least 2 weeks, with respect to either placebo or usual care is associated with a significant reduction in both systolic and diastolic blood pressure. However the effect size of blood pressure reduction is modest.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Fava: The results are in line with previous meta-analyses, but the inclusion of 30 primary studies allowed us meaningful analyses in subgroups. The fact that most of the results remain unaltered even excluding low quality studies with gives us a reassurance about the reliability of the results.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Fava: We think that, due to its beneficial effect on blood pressure, cPAP can be considered an important adjuvant therapy to lower blood pressure, especially in patients suffering from OSA with frequent apneic/hypopneic episodes and severe somnolence. On the other hand, the small effect size  should alert physicians to the fact that in most patients, normalization of blood pressure only by cPAP is seldom possible.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Fava: Further studies are needed especially in patients with resistant or refractory forms of hypertension, where the effect of cPAP could be higher. Moreover intervention studies on hard end-points, such as cardiovascular events incidence, are lacking.

Citation:

Effect of Continuous Positive Airway Pressure (CPAP) on Blood Pressure in Patients With Obstructive Sleep Apnea/Hypopnea. A Systemic Review and Meta-Analysis

Chest 2013 Sep 26;[EPub Ahead of Print], C Fava, S Dorigoni, F Dalle Vedove, E Danese, M Montagnana, GC Guidi, K Narkiewicz, P MinuzResearch October 07, 2013