A new meta-analysis aimed to examine the effect of CPAP therapy on cardiovascular events in obstructive sleep apnea patients, as reported by Medscape.

Serious cardiovascular outcomes, including mortality, are associated with obstructive sleep-disordered breathing. Given that obstructive sleep apnea (OSA) is quite common in both men and women aged 50 years or older, it remains important to determine whether treatment of OSA might improve cardiac outcomes of patients who also have cardiovascular disorders. Previous studies have not provided a clear answer, largely because they were underpowered.[1]

The current study was a meta-analysis of 18 large, prospective, randomized, controlled studies with a total of 4146 patients. The included studies had “cardiovascular,” “mortality,” or “blood pressure” in their titles and comparing outcomes of patients given continuous positive airway pressure (CPAP) with those in patients who received sham therapy or with untreated control participants. The mean age was 63.4 years, and 75% of participants were male. Smokers and patients with type 2 diabetes were included.

The mean duration of CPAP administration was 5 hours per night, and the mean duration of follow-up was 30.5 months. The Epworth Sleepiness Scale was reduced in the CPAP group by -1.78 units (P < .001), suggesting that CPAP had been performed.

The risk for cardiovascular events of any type was slightly reduced in the CPAP group vs control (odds ratio, 0.84), but statistical significance was not reached (P = .53. Mortality, which was recorded in four studies involving 2020 participants), was again only slightly reduced in the CPAP arm (odds ratio, 0.85) and nonsignificant (P =.72). Stroke was similarly slightly lower but also nonsignificant. However, both systolic and diastolic blood pressures were significantly reduced, at -2.03 mm Hg and -1.79 mm Hg, respectively.

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