Effect of CPAP therapy on blood pressure in patients with obstructive sleep apnoea: a worldwide individual patient data meta-analysis.

The aim of this individual patient data (IPD) meta-analysiswas to understand which OSA phenotypes could benefit the most in terms of BP reduction.

本项个体患者数据（IPD）荟萃分析的目的是了解哪些OSA表型在血压降低方面最能受益。

Methods

A systematic reviewof randomised controlled trials that compared continuous positive airway pressure (CPAP) with either passive or active treatment was conducted.

进行了一项系统评价，比较了持续气道正压通气（CPAP）与被动或主动治疗的随机对照试验。

Studies were eligible if they included adult patients with OSA diagnosed by full polysomnography or cardiorespiratory polygraphy (defined as apnoea-hypopnoea index >5 events·h-1) and if BP was measured both before and after CPAP treatment.

如果研究包括了通过全面多导睡眠图或心肺多导睡眠图（定义为呼吸暂停低通气指数>5次/小时）诊断的成人OSA患者，并且在CPAP治疗前后都测量了血压，则该研究符合纳入标准。

Results

In total, 36 parallel studies (n=9434 patients) were included.

总共纳入了36项并行研究（n=9434名患者）。

CPAP treatment was associated with BP reduction in patients with uncontrolled office SBP only, while BP was not reduced by CPAP in patients with controlled BP (SBP -2.6 versus 0 mmHg; p<0.0001; DBP -1.7 versus -1 mmHg; p=0.091).

仅在办公室收缩压未控制的患者中，持续气道正压通气（CPAP）治疗与血压降低相关，而在血压已控制的患者中，CPAP并未降低血压（收缩压降低2.6毫米汞柱对比0毫米汞柱；p<0.0001；舒张压降低1.7毫米汞柱对比1毫米汞柱；p=0.091）。

Differences were seen also when BP changes were compared between patients aged ≤60 versus >60 years after multiple imputation only (p=0.0127 for SBP and p=0.017 for DBP).

在进行多重插补后，比较了年龄≤60岁与>60岁患者的血压变化，发现收缩压（SBP）和舒张压（DBP）的差异具有统计学意义（p=0.0127和p=0.017）。

No differences were seen in terms of BP reduction when comparing patients with/without severe nocturnal hypoxia.

在比较有/无严重夜间低氧血症的患者时，未发现血压降低方面的差异。

Conclusions

This IPD meta-analysisof the BP effects of OSA treatment with CPAP shows that OSA patients with uncontrolled BP at baseline benefit the most from CPAP therapy in terms of BP reduction.

这项针对阻塞性睡眠呼吸暂停（OSA）患者接受持续气道正压通气（CPAP）治疗的血压（BP）影响的个体患者数据（IPD）荟萃分析显示，基线时血压未得到控制的OSA患者从CPAP治疗中获得的血压降低益处最大。

These results have important implications for the decision on how to best manage arterial hypertension associated with OSA.

这些结果对于决定如何最好地管理与OSA相关的动脉高血压具有重要意义。