• Andressa S O Schein, Alessandra C Kerkhoff, Christian C Coronel, Rodrigo D M Plentz, and Graciele Sbruzzi.
• aInstituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia bUniversidade Federal do Rio Grande do Sul cUniversidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
• J. Hypertens. 2014 Sep 1;32(9):1762-73.

BackgroundObstructive sleep apnea (OSA) may lead to the development of hypertension and therapy with continuous positive airway pressure (CPAP) can promote reduction in blood pressure.ObjectiveThe objective of this study is to review systematically the effects of CPAP on blood pressure in patients with OSA.MethodsThe search was conducted in the following databases, from their beginning until February 2013: MEDLINE, Embase, Cochrane CENTRAL, Lilacs and PEDro. In addition, a manual search was performed on references of published studies. Randomized clinical trials (RCTs) that used CPAP compared with placebo CPAP or subtherapeutic CPAP for treatment of patients with OSA and that evaluated office SBP and DBP and 24-h ambulatory blood pressure were selected.ResultsSixteen RCTs were included among 3409 publications, totaling 1166 patients. The use of CPAP resulted in reductions in office SBP [-3.20  mmHg; 95% confidence interval (CI) -4.67 to -1.72] and DBP (-2.87  mmHg; 95% CI -5.18 to -0.55); in night-time SBP (-4.92  mmHg; 95% CI -8.70 to -1.14); in mean 24-h blood pressure (-3.56  mmHg; 95% CI -6.79 to -0.33), mean night-time blood pressure (-2.56  mmHg; 95% CI -4.43 to -0.68) and 24-h DBP (-3.46  mmHg; 95% CI -6.75 to -0.17). However, no significant change was observed in daytime SBP (-0.74  mmHg; 95% CI -3.90 to 2.41) and daytime DBP (-1.86  mmHg; 95% CI -4.55 to 0.83).ConclusionTreatment with CPAP promoted significantly but small reductions in blood pressure in individuals with OSA. Further studies should be performed to evaluate the effects of long-term CPAP and the impact on cardiovascular risk.

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