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. 2020 Sep 29;15:e65. doi: 10.15420/ecr.2020.10

Table 2: Meta-analyses of Incident Hypertension and Cardiovascular Events in Patients with Obstructive Sleep Apnoea.

Authors Type of Study No. Studies Patients Groups Endpoint Association Pooled RR [95% CI]
Hypertension
Hou et al. 2018[21] Meta-analysis 26 studies 51,623 Mild OSA (AHI ≥5)
Moderate OSA (AHI ≥15)
Severe OSA (AHI ≥30)
OSA (AHI ≥5)
New-onset hypertension
Resistant hypertension
1.18 [1.09–1.27]
1.32 [1.20–1.43]
2.84 [1.70–3.98]
2.84 [1.70–3.98]
Xia et al. 2018[22] Meta-analysis 6 prospective and 1 case–control studies 6,098 AHI ≥5 versus AHI ≥30 New-onset hypertension 1.77 [1.30–2.41]
Cardiovascular Disease
Xie et al. 2017[47] Meta-analysis 16 cohort studies (11 studies in primary prevention) 24,308 Severe OSA (AHI ≥30) CHD
Stroke
Heart failure
CV mortality
All-cause mortality
1.63 [1.18–2.26]
2.15 [1.42–3.24]
1.44 [0.94–2.21]
2.96 [1.45–6.01]
1.54 [1.21–1.97]
Prevention Studies (CPAP)
da Silva and Zhang 2019[55] Meta-analysis 9 RCTs 3,314 CPAP versus control MI
Stroke
CV mortality
All-cause mortality
1.11 [0.76–1.62]
0.77 [0.46–1.28]
0.58 [0.19–1.74]
0.86 [0.60–1.23]
Khan et al. 2018[56] Meta-analysis 7 RCTs 4,268 CPAP versus control MACE*
MACE*(≥4 h/night of CPAP use)
AF/AFl
MI
Stroke
CV mortality
All-cause mortality
0.74 [0.47–1.17]
0.43 [0.23–0.80]
0.87 [0.38–1.97]
0.99 [0.57–1.72]
0.95 [0.72–1.24]
0.70 [0.27–1.80]
0.95 [0.67–1.34]
Deng et al. 2018[45] Meta-analysis 10 studies (3 RCTs) 1,217 CPAP versus control Recurrent AF (after catheter ablation) 0.60 [0.51–0.70]

*Non-fatal MI, stroke and cardiovascular mortality. AFl = atrial flutter; AHI = apnoea-hypopnoea index; CPAP = continuous positive airway pressure; CV = cardiovascular; MACE = major adverse cardiovascular events; OSA = obstructive sleep apnoea; RCT = randomised controlled trial; TIA = transient ischaemic attack.