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Obstructive sleep apnoea treatment and blood pressure: Which phenotypes predict a response? A systematic review and meta-analysis

European Respiratory Journal Mar 04, 2020

Pengo MF, Soranna D, Giontella A, et al. - Given the association of the treatment for obstructive sleep apnea with continuous positive airway pressure (CPAP) or mandibular advancement devices (MAD) with modest blood pressure (BP) reduction, researchers sought to recognize subgroups of patients who respond best to treatment via performing a systematic review and meta-analysis of RCTs comparing the effect of such treatments on BP. Searching three different databases, they identified 2,289 articles; of these, 68 RCTs that compared CPAP or MAD with either passive or active treatment were included. Pooling all the studies together, they identified correlation of CPAP and MAD with an average BP reduction of −2.09 (−2.78, −1.40) mmHg. A greater response was observed in the subgroups of patients who were: younger than 60 years (systolic BP −2.93 mmHg), with uncontrolled BP at baseline (systolic BP −4.14 mmHg) and with severe oxygen desaturations (SpO2-nadir < 77%) at baseline (24 h systolic BP −7.57 mmHg).
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