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

Autor: Cuspidi, Cesare, Tadic, Marijana, Sala, Carla, Gherbesi, Elisa, Grassi, Guido, Mancia, Giuseppe
Přispěvatelé: Cuspidi, C, Tadic, M, Sala, C, Gherbesi, E, Grassi, G, Mancia, G
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Journal of Clinical Medicine
Volume 8
Issue 9
Journal of Clinical Medicine, Vol 8, Iss 9, p 1367 (2019)
Popis: 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: &ldquo
obstructive sleep apnea&rdquo
&ldquo
sleep quality&rdquo
non dipping&rdquo
reduced nocturnal BP fall&rdquo
circadian BP variation&rdquo
night-time BP&rdquo
and &ldquo
ambulatory blood pressure monitoring&rdquo
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&ndash
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&ndash
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&ndash
1.89, p <
0.01). After the exclusion of patients with mild OSA, OR increased to 1.67 (CI: 1.21&ndash
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.
Databáze: OpenAIRE