title: Effect of continuous positive airway pressure treatment on pulmonary artery pressure in patients with isolated obstructive sleep apnea: a meta-analysis.
abstract: Pulmonary hypertension (PH) can occur in patients with obstructive sleep apnea (OSA) in the absence of cardiac or lung disease. Data on the development and severity of PH, and the effect of continuous positive airway pressure (CPAP) therapy on pulmonary artery (PA) pressures in these patients have been inconsistent in the literature. We sought to determine whether CPAP therapy affects PA pressures in patients with isolated OSA in this meta-analysis. We searched PubMed, Medline, EMBASE and other databases from January 1980 to August 2015. Studies of patients with OSA, defined as an apnea-hypopnea index >10 events/h, and PH, defined as PA pressure >25 mmHg were included. Two reviewers independently extracted data and assessed risk of bias. A total of 222 patients from seven studies (341.53 person-years) had reported PA pressures before and after treatment with CPAP therapy. 77 % of participants were men, with a mean age of 52.5 years, a mean apnea-hypopnea index of 58 events/h, and mean PA pressure of 39.3 ± 6.3 mmHg. CPAP treatment duration ranged from 3 to 70 months. Using fixed effects meta-analysis, CPAP therapy was associated with a decrease in PA pressure of 13.3 mmHg (95 % CI 12.7-14.0) in our study population. This meta-analysis found that CPAP therapy is associated with a significantly lower PA pressure in patients with isolated OSA and PH.
authors.affiliation: Department of Medicine, Brigham & Women's Hospital, VA Boston Healthcare System, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA. TFImran@partners.org.
authors.forename: Tasnim F
authors.initials: TF
authors.lastname: Imran
authors.affiliation: Department of Population Health, New York University Langone Medical Center, 650 First Avenue, New York, NY, 10001, USA.
authors.forename: Marya
authors.initials: M
authors.lastname: Ghazipura
authors.affiliation: Heart Failure and Pulmonary Hypertension Program, Rutgers, New Jersey Medical School, 30 Prospect St, Hackensack, NJ, 07103, USA.
authors.forename: Spencer
authors.initials: S
authors.lastname: Liu
authors.affiliation: Heart Failure and Pulmonary Hypertension Program, Rutgers, New Jersey Medical School, 30 Prospect St, Hackensack, NJ, 07103, USA.
authors.forename: Tanzib
authors.initials: T
authors.lastname: Hossain
authors.affiliation: Heart Failure and Pulmonary Hypertension Program, Rutgers, New Jersey Medical School, 30 Prospect St, Hackensack, NJ, 07103, USA.
authors.forename: Hormoz
authors.initials: H
authors.lastname: Ashtyani
authors.affiliation: Heart Failure and Pulmonary Hypertension Program, Rutgers, New Jersey Medical School, 30 Prospect St, Hackensack, NJ, 07103, USA.
authors.forename: Bernard
authors.initials: B
authors.lastname: Kim
authors.affiliation: Department of Medicine, Brigham & Women's Hospital, VA Boston Healthcare System, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA.
authors.forename: J
authors.initials: J
authors.lastname: Michael Gaziano
authors.affiliation: Department of Medicine, Brigham & Women's Hospital, VA Boston Healthcare System, Harvard Medical School, 1620 Tremont St, Boston, MA, 02120, USA.
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology / Q000628:therapy*; D011651:Pulmonary Artery / Q000503:physiopathology*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000628:therapy*
keywords: Continuous positive airway pressure; Obstructive sleep apnea; Pulmonary artery pressure; Pulmonary hypertension