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Open AccessArticle

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

1
Department of Medicine and Surgery, University of Milano-Bicocca, 20036 Meda, Italy
2
Istituto Auxologico Italiano, 20122 Milano, Italy
3
Department of Internal Medicine and Cardiology, Charité–Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353 Berlin, Germany
4
Department of Clinical Sciences and Community Health, University of Milano and Fondazione Ospedale Maggiore IRCCS Policlinico di Milano, 20122 Milano, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(9), 1367; https://doi.org/10.3390/jcm8091367
Received: 31 July 2019 / Revised: 22 August 2019 / Accepted: 30 August 2019 / Published: 2 September 2019
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. View Full-Text
Keywords: obstructive sleep apnea; non-dipping pattern; meta-analysis obstructive sleep apnea; non-dipping pattern; meta-analysis
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Cuspidi, C.; Tadic, M.; Sala, C.; Gherbesi, E.; Grassi, G.; Mancia, G. Blood Pressure Non-Dipping and Obstructive Sleep Apnea Syndrome: A Meta-Analysis. J. Clin. Med. 2019, 8, 1367.

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