Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, PR China.
Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.
Hypertens Res. 2022 Nov;45(11):1802-1813. doi: 10.1038/s41440-022-00954-9. Epub 2022 Jun 14.
This meta-analysis was performed to determine the effects of continuous positive airway pressure (CPAP) on blood pressure (BP) in patients with systemic hypertension and obstructive sleep apnea (OSA). A systematic search was conducted using PubMed, Embase, Web of Science, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials on the treatment of hypertension and OSA with CPAP, compared with sham CPAP or no CPAP, were reviewed. Studies were pooled to obtain weighted mean differences (WMDs) with 95% confidence intervals (CIs). Nineteen trials (enrolling 1904 participants) met the inclusion criteria. CPAP had significant effects on 24-h systolic blood pressure (SBP) (WMD -5.01 mmHg, 95% CI -6.94 to -3.08; P < 0.00001), 24-h diastolic blood pressure (DBP) (WMD -3.30 mmHg, 95% CI -4.32 to -2.28; P < 0.00001), daytime SBP (WMD -4.34 mmHg, 95% CI -6.27 to -2.40; P < 0.0001), daytime DBP (WMD -2.97 mmHg, 95% CI -3.99 to -1.95; P < 0.00001), nighttime SBP (WMD -3.55 mmHg, 95% CI -5.08 to -2.03; P < 0.00001), nighttime DBP (WMD -2.33 mmHg, 95% CI -3.27 to -1.40; P < 0.00001), office SBP (WMD -3.67 mmHg, 95% CI -5.76 to -1.58; P = 0.0006), office DBP (WMD -2.61 mmHg, 95% CI -4.25 to -0.97; P = 0.002), and heart rate (WMD -2.79 beats/min, 95% CI -4.88 to -0.71; P = 0.009). CPAP treatment was associated with BP reduction in patients with systemic hypertension and OSA, except when the follow-up period was shorter than 3 months.
这项荟萃分析旨在确定持续气道正压通气（CPAP）对合并阻塞性睡眠呼吸暂停（OSA）的高血压患者血压（BP）的影响。使用 PubMed、Embase、Web of Science、Cochrane Library 和 clinicaltrials.gov 进行了系统检索，没有语言限制。综述了 CPAP 治疗高血压和 OSA 的随机对照试验，与假 CPAP 或无 CPAP 相比。将研究汇总以获得具有 95%置信区间（CI）的加权均数差（WMD）。19 项试验（纳入 1904 名参与者）符合纳入标准。CPAP 对 24 小时收缩压（SBP）（WMD-5.01mmHg，95%CI-6.94 至-3.08；P<0.00001）、24 小时舒张压（DBP）（WMD-3.30mmHg，95%CI-4.32 至-2.28；P<0.00001）、日间 SBP（WMD-4.34mmHg，95%CI-6.27 至-2.40；P<0.0001）、日间 DBP（WMD-2.97mmHg，95%CI-3.99 至-1.95；P<0.00001）、夜间 SBP（WMD-3.55mmHg，95%CI-5.08 至-2.03；P<0.00001）、夜间 DBP（WMD-2.33mmHg，95%CI-3.27 至-1.40；P<0.00001）、诊室 SBP（WMD-3.67mmHg，95%CI-5.76 至-1.58；P=0.0006）、诊室 DBP（WMD-2.61mmHg，95%CI-4.25 至-0.97；P=0.002）和心率（WMD-2.79 次/分钟，95%CI-4.88 至-0.71；P=0.009）均有显著影响。CPAP 治疗与合并高血压和 OSA 患者的 BP 降低相关，除非随访时间短于 3 个月。
