title: The effects of continuous positive airways pressure therapy on cardiovascular end points in patients with sleep-disordered breathing and heart failure: a meta-analysis of randomized controlled trials.
abstract: In patients with sleep-disordered breathing and heart failure, continuous positive airway pressure has been found to be associated with an improvement in cardiovascular end points. We conducted a systematic review of the current literature and a meta-analysis to pool data from 15 published randomized controlled trials. End points analyzed were left ventricular ejection fraction, diastolic blood pressure, systolic blood pressure, heart rate, and mortality. A fixed effects model was used for end points demonstrating homogeneity among included studies, whereas a random effects model was used for end points demonstrating heterogeneity among included studies. A significant improvement in left ventricular ejection fraction was noted with continuous positive airway pressure (mean difference, 5.05%; 95% confidence interval [CI]: 3.72 to 6.38), diastolic blood pressure (mean difference, −1.67; 95% CI: −3.09 to −0.25), and heart rate (mean difference, −5.92; 95% CI: −10.12 to−1.72). No significant changes in mortality (odds ratio, 0.63; 95% CI: 0.40 to 1.00) and systolic blood pressure were noted (mean difference, −6.35; 95% CI: −16.11 to 2.41). The analysis also revealed the need for additional studies to clarify the associations noted and the presence of publication bias with small studies with a paucity of small studies with negative results. In this meta-analysis, treatment with continuous positive airways pressure was associated with improvements in ejection fraction, diastolic blood pressure, and heart rate in patients with sleep-disordered breathing and congestive heart failure.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Aggarwal
authors.forename: Rashid
authors.initials: R
authors.lastname: Nadeem
authors.forename: Rohit S
authors.initials: RS
authors.lastname: Loomba
authors.forename: Mahwish
authors.initials: M
authors.lastname: Nida
authors.forename: Dorice
authors.initials: D
authors.lastname: Vieira
mesh_terms: D001794:Blood Pressure; D016009:Chi-Square Distribution; D045422:Continuous Positive Airway Pressure; D003971:Diastole; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D016017:Odds Ratio; D020127:Recovery of Function; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013318:Stroke Volume; D016896:Treatment Outcome; D016277:Ventricular Function, Left