Effectiveness of continuous positive airway pressure in lowering blood pressure in patients with obstructive sleep apnea: a critical review of the literature

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2016
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Abstract
Effectiveness of continuous positive airway pressure in lowering blood pressure in patients with obstructive sleep apnea: a critical review of the literature Fernanda Fatureto-Borges,1 Geraldo Lorenzi-Filho,2 Luciano F Drager1,3 1Hypertension Unit, Heart Institute (InCor), 2Sleep Laboratory, Pulmonary Division, 3Hypertension Unit, Renal Division, University of Sao Paulo Medical School, Sao Paulo, Brazil Abstract: Obstructive sleep apnea (OSA) is an extremely common comorbid condition in patients with hypertension, with a prevalence of ~50%. There is growing evidence suggesting that OSA is a secondary cause of hypertension, associated with both poor blood pressure (BP) control and target organ damage in patients with hypertension. The application of continuous positive airway pressure (CPAP) during sleep is the gold standard treatment of moderate- to-severe OSA and very effective in abolishing obstructive respiratory events. However, several meta-analyses showed that the overall impact of CPAP on BP is modest (~2 mmHg). There are several potential reasons for this disappointing finding, including the heterogeneity of patients studied (normotensive patients, controlled, and uncontrolled patients with hypertension), nonideal CPAP compliance, clinical presentation (there is some evidence that the positive impact of CPAP on lowering BP is more evident in sleepy patients), and the multifactorial nature of hypertension. In this review, we performed a critical analysis of the literature evaluating the impact of CPAP on BP in several subgroups of patients. We finally discussed perspectives in this important research area, including the urgent need to identify predictors of BP response to CPAP and the importance of precision medicine in this scenario. Keywords: cardiovascular disease, CPAP, hypertension, sleep apnea, treatment
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fernanda2016effectivenessintegrated Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Fernanda Fatureto Borges;Geraldo Lorenzi-Filho;Luciano F Drager and
Journal integrated blood pressure control
Year 2016
DOI
10.2147/IBPC.S70402
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