Weight reduction added to CPAP decreases blood pressure and triglyceride level in OSA: Systematic review and meta‐analysis

Abstract 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 hyperte...

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Main Authors: Dóra K. Kovács (Author), Noémi Gede (Author), László Szabó (Author), Péter Hegyi (Author), Zsolt Szakács (Author), Béla Faludi (Author), Ágnes Sebők (Author), András Garami (Author), Margit Solymár (Author), Dániel Kósa (Author), Lilla Hanák (Author), Zoltán Rumbus (Author), Márta Balaskó (Author)
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Published: Wiley, 2022-05-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Dóra K. Kovács  |e author 
700 1 0 |a Noémi Gede  |e author 
700 1 0 |a László Szabó  |e author 
700 1 0 |a Péter Hegyi  |e author 
700 1 0 |a Zsolt Szakács  |e author 
700 1 0 |a Béla Faludi  |e author 
700 1 0 |a Ágnes Sebők  |e author 
700 1 0 |a András Garami  |e author 
700 1 0 |a Margit Solymár  |e author 
700 1 0 |a Dániel Kósa  |e author 
700 1 0 |a Lilla Hanák  |e author 
700 1 0 |a Zoltán Rumbus  |e author 
700 1 0 |a Márta Balaskó  |e author 
245 0 0 |a Weight reduction added to CPAP decreases blood pressure and triglyceride level in OSA: Systematic review and meta‐analysis 
260 |b Wiley,   |c 2022-05-01T00:00:00Z. 
500 |a 1752-8062 
500 |a 1752-8054 
500 |a 10.1111/cts.13241 
520 |a Abstract 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 loss (WL) with CPAP (vs. 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 versus CPAP was −8.89 mmHg, 95% confidence interval (95% CI; −13.67 to −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 to −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. 
546 |a EN 
690 |a Therapeutics. Pharmacology 
690 |a RM1-950 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Clinical and Translational Science, Vol 15, Iss 5, Pp 1238-1248 (2022) 
787 0 |n https://doi.org/10.1111/cts.13241 
787 0 |n https://doaj.org/toc/1752-8054 
787 0 |n https://doaj.org/toc/1752-8062 
856 4 1 |u https://doaj.org/article/8833630c97e1433b80cd2a4a93c4ab8c  |z Connect to this object online.