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

Cesare Cuspidi, Marijana Tadic, Carla Sala, Elisa Gherbesi, Guido Grassi, Giuseppe Mancia

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article numberE1367
JournalJournal of Clinical Medicine
Volume8
Issue number9
DOIs
Publication statusPublished - Sep 2 2019

Fingerprint

Obstructive Sleep Apnea
Meta-Analysis
Blood Pressure
Ambulatory Blood Pressure Monitoring
Sleep Apnea Syndromes
Confidence Intervals
Odds Ratio
PubMed
MEDLINE
Sleep
Cross-Sectional Studies
Databases

Cite this

Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome : A Meta-Analysis. / Cuspidi, Cesare; Tadic, Marijana; Sala, Carla; Gherbesi, Elisa; Grassi, Guido; Mancia, Giuseppe.

In: Journal of Clinical Medicine, Vol. 8, No. 9, E1367, 02.09.2019.

Research output: Contribution to journalArticle

Cuspidi, Cesare ; Tadic, Marijana ; Sala, Carla ; Gherbesi, Elisa ; Grassi, Guido ; Mancia, Giuseppe. / Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome : A Meta-Analysis. In: Journal of Clinical Medicine. 2019 ; Vol. 8, No. 9.
@article{5d3e5d91506a46aba1ac5b51d89c91b0,
title = "Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis",
abstract = "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.",
author = "Cesare Cuspidi and Marijana Tadic and Carla Sala and Elisa Gherbesi and Guido Grassi and Giuseppe Mancia",
year = "2019",
month = "9",
day = "2",
doi = "10.3390/jcm8091367",
language = "English",
volume = "8",
journal = "Journal of Clinical Medicine",
issn = "2077-0383",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "9",

}

TY - JOUR

T1 - Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome

T2 - A Meta-Analysis

AU - Cuspidi, Cesare

AU - Tadic, Marijana

AU - Sala, Carla

AU - Gherbesi, Elisa

AU - Grassi, Guido

AU - Mancia, Giuseppe

PY - 2019/9/2

Y1 - 2019/9/2

N2 - 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.

AB - 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.

U2 - 10.3390/jcm8091367

DO - 10.3390/jcm8091367

M3 - Article

C2 - 31480717

VL - 8

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

SN - 2077-0383

IS - 9

M1 - E1367

ER -