GINOP - STAY ALIVE(GINOP-2.3.2-15-2016-00048) Támogató: Nemzeti Kutatási, Fejlesztési
és Innovációs Hivatal
(GINOP-2.3.4-15-2020-00010)
(EFOP-3.6.1.-16-2016-00004) Támogató: EFOP
Szakterületek:
Metaanalízis
Obstructive sleep apnea (OSA) is associated with treatment-resistant hypertension
and high cardiovascular risk. Continuous positive airway pressure (CPAP) fails to
reduce cardiovascular risks consistently. Obesity and OSA show reciprocal association
and they synergistically increase hypertension via different pathways. Our meta-analysis
aimed to assess the cardiovascular benefits of combining weight reduction (WL) with
CPAP (versus WL or CPAP alone) in OSA. Outcomes included systolic and diastolic blood
pressure (BP) and blood lipid parameters. We explored Medline, Embase, Cochrane and
Scopus. Eight randomized controlled studies (2627 patients) were included. The combined
therapy decreased systolic BP more than CPAP alone. Weighted mean difference (WMD)
for CPAP+WL vs. CPAP was -8.89 mmHg, 95%confidence interval (95%CI)[-13.67; -4.10],
p<0.001 for systolic BP. For diastolic BP this decrease was not significant. In case
of blood lipids, the combined treatment decreased triglyceride levels more than CPAP
alone (WMD= -0.31, 95%CI [-0.58; -0.04] p =0.027). On the other hand, addition of
CPAP to WL failed to suppress BP further. The certainty of evidence according to GRADE
was very low to moderate. In conclusion, our results showed that the addition of WL
to CPAP significantly improved BP and blood lipid values in OSA. On the other hand,
the addition of CPAP to WL could not significantly improve BP or blood lipid values.
Review protocol: PROSPERO CRD42019138998.
