ObjectiveTo Affiliated systematically review the efficacy of continuous positive airway pressure (CPAP) for resistant hypertension (RH) patients with obstructive sleep apnea (OSA).
MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 10, 2015), CBM, CNKI and WanFang Data from inception to March 2016, to collect randomized controlled trials (RCTs) about CPAP for RH patients with OSA. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.
ResultsA total of 5 RCTs involving 395 patients were included. The results of meta-analysis showed that: After 3 months of follow-up, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy could significantly reduce the 24 h diastolic blood pressure (DBP), day DBP, night DBP, 24 h diastolic blood pressure (SBP) and night SBP of RH patients with OSA (MD=-4.79, 95%CI -7.39 to -2.18, P=0.000 3; MD=-2.94, 95%CI -4.99 to -0.89, P=0.005; MD=-3.19, 95%CI -5.84 to -0.55, P=0.02; MD=-4.36, 95%CI -7.38 to -1.33, P=0.005; MD=-4.90, 95%CI -8.72, -1.08, P=0.01), but there was no significant difference between the two groups in day SBP. After 6 months of follow-up, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy could significantly reduce the 24 h DBP, day DBP of RH patients with OSA (MD=-4.89, 95%CI -6.76 to -3.02, P<0.000 01; MD=-5.01, 95%CI -9.58 to -0.45, P=0.03), but there were no significant differences between the two groups in night DBP, 24 h SBP, day SBP, and night SBP.
ConclusionCurrent evidence suggests that CPAP on the basis of antihypertensive drug therapy could effectively reduce the DBP and SBP of RH patients with OSA at short-term follow-up, but the long-term effect on SBP is not obvious. Due to limited quality and quantity of the included studies, the above conclusions need to be verified by more high quality studies.
