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Effect of Antihypertensive Medications on the Severity of Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.
Khurshid, Kiran; Yabes, Jonathan; Weiss, Patricia M; Dharia, Sushma; Brown, Lee; Unruh, Mark; Jhamb, Manisha.
Afiliação
  • Khurshid K; Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Yabes J; Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Weiss PM; Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA.
  • Dharia S; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NM.
  • Brown L; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NM.
  • Unruh M; Nephrology Division, Department of Internal Medicine, University of New Mexico, Albuquerque, NM.
  • Jhamb M; Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
J Clin Sleep Med ; 12(8): 1143-51, 2016 08 15.
Article em En | MEDLINE | ID: mdl-27397663
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is an independent risk factor for hypertension (HTN). Increasing evidence from animal and human studies suggests that HTN exacerbates OSA. We performed a systematic review and meta-analysis of studies evaluating the effect of anti-hypertensive medications on the severity of OSA. METHODS: A literature search of PubMed and Embase was done using search concepts of OSA, HTN, and drug classes used to treat HTN. Studies that reported changes in the severity of OSA objectively by using apnea-hypopnea index (AHI) or respiratory disturbance index (RDI) were included. Pooled mean difference estimates were calculated. Tests for heterogeneity, publication bias, and subgroup sensitivity analysis were conducted. RESULTS: Of 27,376 studies screened, only 11 met inclusion criteria, including 5 randomized controlled trials and 6 single-arm prospective trials. The pooled mean difference estimate (95% confidence interval [CI]), based on a random-effects model, was -5.69 (95% CI -10.74 to -0.65), consistent with an overall decrease in AHI or RDI attributable to antihypertensive medications. The effect size was even more pronounced, -14.52 (95% CI -25.65 to -3.39), when only studies using diuretics were analyzed. There was no significant heterogeneity or publication bias among the studies. Meta-regression indicated neither age, baseline AHI, nor change in systolic/diastolic blood pressure influenced the results. CONCLUSIONS: Collectively, findings from these relatively small, short-term studies tend to support the contention that treatment with antihypertensive agents confers a statistically significant, albeit small, reduction in the severity of OSA, which may be more pronounced with the use of diuretics.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apneia Obstrutiva do Sono / Hipertensão / Anti-Hipertensivos Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Clin Sleep Med Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apneia Obstrutiva do Sono / Hipertensão / Anti-Hipertensivos Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: J Clin Sleep Med Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos