. Author manuscript; available in PMC: 2024 Jan 1.

Published in final edited form as: Int Forum Allergy Rhinol. 2023 Mar 30;13(7):1061–1482. doi: 10.1002/alr.23079

TABLE IX.E.4.

Evidence for blood pressure change after surgery for OSA

Study	Year	LOE	Study design	Study groups	Clinical end-point	Conclusion
Fehrm et al.²⁰³⁹	2017	1b	Randomized controlled trial	65 patients 1. UPPP (n = 32) 2. CPAP (n = 33) Crossover of CPAP group at 6 months	SBP and DBP at 6–24 months	Larger SBP and DBP reductions seen in surgical group compared to CPAP group. (SBP difference −9.4 mmHg and DBP difference −6.4 mmHg postsurgery vs. −2.6 mmHg SBP and −2.0 mmHg DBP with CPAP)
Chin et al.²⁰³⁸	2019	4	Case series	89 patients that underwent multilevel ST surgery	Serum leptin, cholesterol, SBP, DBP, and triglycerides	Morning SBP improvements in surgical responders (mean difference −7.2 mmHg after surgery). Nocturnal BP change was not significant.
De Paula Soares et al.¹⁷¹⁴	2014	4	Case series	18 patients underwent ST surgery	ABPM before and 6 months after surgery	SBP, DBP, and MAP during sleep were significantly decreased after surgery. (SBP: −7.4 mmHg, DBP: −4.2 mmHg, MAP: −5.3 mmHg).
Rotenberg et al.¹⁴⁹⁹	2014	4	Case series	A total of patients underwent ST surgery ± nasal surgery	AHI, ESS, SAQLI, SBP	SBP significantly reduced after surgery. (SBP difference −8.7 mmHg after surgery vs. no difference with CPAP).
Boyd et al.²⁰⁰⁵	2019	4	Case series	30 patients that underwent MMA	ESS, FOSQ, AHI, PVT, SBP, DBP, and CRP	Significant DBP reduction seen (mean difference −3.3 mmHg).
Islam et al.²⁰⁴⁰	2015	4	Case series	45 patients that underwent MMA	Pre and PO SBP and DBP measurements	SBP significantly reduced after surgery (mean difference −3.8 mmHg). DBP change was not significant.
Boyd et al.²⁰⁴¹	2015	4	Case series	30 patients that underwent MMA followed for >2 years (average 6 years)	AHI, ESS, FOSQ, SBP, and DBP	Reductions in DBP were seen in patients followed for at least >2 years (mean difference −4.7 mmHg).

Abbreviations: ABPM, 24 h ambulatory blood pressure monitoring; AHI, apnea/hypopnea index; CRP, C reactive protein; DBP, diastolic blood pressure; ESS, Epworth Sleepiness Scale; FOSQ, functional outcomes of sleep questionnaire; LOE, level of evidence; MAP, mean arterial pressure; MMA, maxillomandibular advancement; PO, postoperative; PVT, psychomotor vigilance testing; SAQLI, sleep apnea quality of life index; SBP, systolic blood pressure; ST, soft tissue.