Cargando…

Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis

Aim: We examined the reduced blood pressure (BP) nocturnal fall in patients with obstructive sleep apnea (OSA) by a meta-analysis including studies that provided data on prevalence rates of non-dipping (ND) pattern during 24-h ambulatory blood pressure monitoring (ABPM). Design: The PubMed, OVID-MED...

Descripción completa

Detalles Bibliográficos
Autores principales: Cuspidi, Cesare, Tadic, Marijana, Sala, Carla, Gherbesi, Elisa, Grassi, Guido, Mancia, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780266/
https://www.ncbi.nlm.nih.gov/pubmed/31480717
http://dx.doi.org/10.3390/jcm8091367
_version_ 1783457091561717760
author Cuspidi, Cesare
Tadic, Marijana
Sala, Carla
Gherbesi, Elisa
Grassi, Guido
Mancia, Giuseppe
author_facet Cuspidi, Cesare
Tadic, Marijana
Sala, Carla
Gherbesi, Elisa
Grassi, Guido
Mancia, Giuseppe
author_sort Cuspidi, Cesare
collection PubMed
description Aim: We examined the reduced blood pressure (BP) nocturnal fall in patients with obstructive sleep apnea (OSA) by a meta-analysis including studies that provided data on prevalence rates of non-dipping (ND) pattern during 24-h ambulatory blood pressure monitoring (ABPM). Design: The PubMed, OVID-MEDLINE, and Cochrane CENTRAL literature databases were searched for appropriate articles without temporal restriction up to April 2019 through focused and sensitive search methods. Studies were identified by crossing the search terms as follows: “obstructive sleep apnea”, “sleep quality”, “non dipping”, “reduced nocturnal BP fall”, “circadian BP variation”, “night-time BP”, and “ambulatory blood pressure monitoring”. Results: Meta-analysis included 1562 patients with OSA from different clinical settings and 957 non-OSA controls from 14 studies. ND pattern prevalence in patients with OSA widely varied among studies (36.0–90.0%). This was also the case for non-OSA controls (33.0% to 69.0%). Overall, the ND pattern, assessed as an event rate in the pooled OSA population, was 59.1% (confidence interval (CI): 52.0–65.0%). Meta-analysis of the seven studies comparing the prevalence of ND pattern in participants with OSA and controls showed that OSA entails a significantly increased risk of ND (Odds ratio (OR) = 1.47, CI: 1.07–1.89, p < 0.01). After the exclusion of patients with mild OSA, OR increased to 1.67 (CI: 1.21–2.28, p < 0.001). Conclusions: The present meta-analysis, extending previous information on the relationship between OSA and impaired BP dipping, based on single studies, suggests that this condition increases by approximately 1.5 times the likelihood of ND, which is a pattern associated with a greater cardiovascular risk than normal BP dipping.
format Online
Article
Text
id pubmed-6780266
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-67802662019-10-30 Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis Cuspidi, Cesare Tadic, Marijana Sala, Carla Gherbesi, Elisa Grassi, Guido Mancia, Giuseppe J Clin Med Article Aim: We examined the reduced blood pressure (BP) nocturnal fall in patients with obstructive sleep apnea (OSA) by a meta-analysis including studies that provided data on prevalence rates of non-dipping (ND) pattern during 24-h ambulatory blood pressure monitoring (ABPM). Design: The PubMed, OVID-MEDLINE, and Cochrane CENTRAL literature databases were searched for appropriate articles without temporal restriction up to April 2019 through focused and sensitive search methods. Studies were identified by crossing the search terms as follows: “obstructive sleep apnea”, “sleep quality”, “non dipping”, “reduced nocturnal BP fall”, “circadian BP variation”, “night-time BP”, and “ambulatory blood pressure monitoring”. Results: Meta-analysis included 1562 patients with OSA from different clinical settings and 957 non-OSA controls from 14 studies. ND pattern prevalence in patients with OSA widely varied among studies (36.0–90.0%). This was also the case for non-OSA controls (33.0% to 69.0%). Overall, the ND pattern, assessed as an event rate in the pooled OSA population, was 59.1% (confidence interval (CI): 52.0–65.0%). Meta-analysis of the seven studies comparing the prevalence of ND pattern in participants with OSA and controls showed that OSA entails a significantly increased risk of ND (Odds ratio (OR) = 1.47, CI: 1.07–1.89, p < 0.01). After the exclusion of patients with mild OSA, OR increased to 1.67 (CI: 1.21–2.28, p < 0.001). Conclusions: The present meta-analysis, extending previous information on the relationship between OSA and impaired BP dipping, based on single studies, suggests that this condition increases by approximately 1.5 times the likelihood of ND, which is a pattern associated with a greater cardiovascular risk than normal BP dipping. MDPI 2019-09-02 /pmc/articles/PMC6780266/ /pubmed/31480717 http://dx.doi.org/10.3390/jcm8091367 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cuspidi, Cesare
Tadic, Marijana
Sala, Carla
Gherbesi, Elisa
Grassi, Guido
Mancia, Giuseppe
Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis
title Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis
title_full Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis
title_fullStr Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis
title_full_unstemmed Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis
title_short Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis
title_sort blood pressure non-dipping and obstructive sleep apnea syndrome: a meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780266/
https://www.ncbi.nlm.nih.gov/pubmed/31480717
http://dx.doi.org/10.3390/jcm8091367
work_keys_str_mv AT cuspidicesare bloodpressurenondippingandobstructivesleepapneasyndromeametaanalysis
AT tadicmarijana bloodpressurenondippingandobstructivesleepapneasyndromeametaanalysis
AT salacarla bloodpressurenondippingandobstructivesleepapneasyndromeametaanalysis
AT gherbesielisa bloodpressurenondippingandobstructivesleepapneasyndromeametaanalysis
AT grassiguido bloodpressurenondippingandobstructivesleepapneasyndromeametaanalysis
AT manciagiuseppe bloodpressurenondippingandobstructivesleepapneasyndromeametaanalysis