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Sivri F, Türköz I, Şencan M, İçen YK, Aksoy F, Ceyhan BÖ. Does COVID-19 Cause Non-Dıpper Hypertension? Angiology 2023:33197231209584. [PMID: 37864346 DOI: 10.1177/00033197231209584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Coronavirus disease 2019 (COVID-19) remains a health problem worldwide. The present study aimed to investigate the effect of blood pressure (BP) on the circadian pattern and prevalence of new-onset non-dipper hypertension in the post-COVID period in patients with known hypertension. This prospective single-center study included 722 patients hospitalized for COVID-19 infection. Ambulatory BP (ABP) data were collected during their initial hospitalization. The ABP data were reassessed 1 month after the patients were discharged. The results were compared with a healthy control group with known hypertension but without COVID-19 infection. After exclusion criteria were applied, the study included 187 patients with COVID-19 and 136 healthy hypertensive controls. Post-COVID ABP showed that patients with COVID-19 had significantly higher mean 24-h systolic and diastolic BP, mean nighttime systolic and diastolic BP, and mean daytime diastolic BP than the control group. In addition, new-onset non-dipper hypertension was significantly higher in patients with COVID-19. This study demonstrated for the first time that the circadian pattern is disturbed and a non-dipper pattern develops in individuals with known hypertension during the post-COVID period.
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Affiliation(s)
- Fatih Sivri
- Aydin Nazilli State Hospital, Nazilli, Turkey
| | - Ismail Türköz
- Department of Infectious Diseases, Dortyol State Hospital, Hatay, Turkey
| | - Mehtap Şencan
- Department of Infectious Diseases, Dortyol State Hospital, Hatay, Turkey
| | - Yahya Kemal İçen
- Department of Cardiology, Adana Health Practice and Research, Adana, Turkey
| | - Fatih Aksoy
- Department of Cardiology, Süleyman Demirel University, Isparta, Turkey
| | - Banu Öztürk Ceyhan
- Department Of Endocrine Diseases, Adnan Menderes University, Aydın, Turkey
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2
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Dube SR, Dube M, Damle S, Patil A. Ambulatory Blood Pressure Monitoring: Our Experience in Routine Clinical Practice. Cureus 2021; 13:e17390. [PMID: 34584800 PMCID: PMC8457258 DOI: 10.7759/cureus.17390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 12/02/2022] Open
Abstract
Objective: To evaluate feasibility and usefulness of ambulatory blood pressure monitoring (ABPM) in outpatient setting. Material and methods: In this prospective study, data of 58 patients who were evaluated with ABPM for diagnosis or therapeutic efficacy purpose were collected from their records. Demographic details of these were recorded. Patients were categorized into different categories based on 24 hours BP pattern. Dipping pattern was compared based on the gender, age, and presence of diabetes or hypertension. Number of patients diagnosed as hypertensive with ABPM reports was compared with office and home BP measurement. Results: Fifty-eight patients (mean age 57.8 years; 70.69% males) were included of whom 22 (37.93%) underwent ABPM for diagnostic purposes. There was gender-wise significant difference in terms of purpose of performing ABPM (p=0.040). Diabetes was present in 22 (37.93%) patients. Out of 36 known hypertensive patients, 17 (47.22%) patients were receiving dual therapy. Out of 45 patients whose records for active BP variability were available, 26 (57.78%) had high variability. The number and percentage of dippers, extreme dippers and reverse dippers as 23 (42.79%), three (5.56%), and six (11.11%), respectively. Depending on the age, there was significant difference in the dipping pattern (p=0.013). On office blood pressure measurement, 35 (64.81%) patients were found to have hypertension. ABPM revealed hypertension in 32 (59.26%). Masked hypertension and white-coat hypertension was observed in nine (16.17%) and 12 (22.22%) patients, respectively. Conclusion: ABPM is feasible and useful in routine outpatient clinical practice for diagnosis of essential hypertension, pattern of dipping, masked hypertension, and white-coat hypertension and also for the therapeutic evaluation of patients in clinical practice.
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Affiliation(s)
- Sunil R Dube
- Medicine, DY Patil deemed to be University School of Medicine, Navi Mumbai, IND
| | - Manjree Dube
- Family Physician, Shyamlata Clinic, Chembur, Mumbai, IND
| | - Sayali Damle
- Geriatrics, DY Patil deemed to be University School of Medicine, Navi Mumbai, IND
| | - Anant Patil
- Pharmacology, DY Patil deemed to be University School of Medicine, Navi Mumbai, IND
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3
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Boix-Castejón M, Herranz-López M, Olivares-Vicente M, Campoy P, Caturla N, Jones J, Zazo JM, Roche E, Micol V. Effect of metabolaid® on pre- and stage 1 hypertensive patients: A randomized controlled trial. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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4
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Zhang Z, Wang S, Yan J, Xu Z, Liang D, Liu B, Liang J, Chen M. Comparing differences and correlation between 24-hour ambulatory blood pressure and office blood pressure monitoring in patients with untreated hypertension. J Int Med Res 2021; 49:3000605211016144. [PMID: 34187215 PMCID: PMC8252350 DOI: 10.1177/03000605211016144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective We assessed differences and correlations between 24-hour ambulatory blood pressure (ABP) and office blood pressure (OBP) monitoring. Methods We conducted an observational study among 85 untreated patients with essential hypertension and measured 24-hour ABP, OBP, target organ damage (TOD) markers, and metabolism indexes. Variance analysis and the Pearson method were used to compare differences and correlation between the two methods. The Spearman or Pearson method was applied to compare the correlation between TOD markers, blood pressure index, and metabolism index. Linear regression analysis was applied to estimate the quantitative relationship between the blood pressure index and TOD markers. Results There were significant differences in the mean and variance of systolic blood pressure (SBP) and diastolic blood pressure and a positive correlation between ABP and OBP. Correlations between the left ventricular mass index (LVMI) and average ambulatory SBP, daytime ambulatory SBP, nighttime ambulatory SBP, and fasting blood glucose were significant. Correlations between left intima-media thickness (IMT) and average ambulatory SBP, nighttime ambulatory SBP, right IMT, and nighttime ambulatory SBP were significant. In linear regression analysis of the LVMI (y) and ambulatory SBP (x), the equation was expressed as y = 0.637*x. Conclusion Nighttime ambulatory SBP may be an optimal predictor of TOD.
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Affiliation(s)
- Zhenhong Zhang
- Department of Cardiology, The Second People's Hospital of Foshan (The Affiliated Hospital at Foshan, Southern Medical University), Foshan, China
| | - Shunyin Wang
- Department of Cardiology, The Second People's Hospital of Foshan (The Affiliated Hospital at Foshan, Southern Medical University), Foshan, China
| | - Junru Yan
- Department of Cardiology, The Second People's Hospital of Foshan (The Affiliated Hospital at Foshan, Southern Medical University), Foshan, China
| | - Zhiwen Xu
- Department of Cardiology, The Second People's Hospital of Foshan (The Affiliated Hospital at Foshan, Southern Medical University), Foshan, China
| | - Dongliang Liang
- Department of Cardiology, The Second People's Hospital of Foshan (The Affiliated Hospital at Foshan, Southern Medical University), Foshan, China
| | - Baohua Liu
- Department of Cardiology, The Second People's Hospital of Foshan (The Affiliated Hospital at Foshan, Southern Medical University), Foshan, China
| | - Junjie Liang
- Department of Cardiology, The Second People's Hospital of Foshan (The Affiliated Hospital at Foshan, Southern Medical University), Foshan, China
| | - Mingjie Chen
- Department of Cardiology, The Second People's Hospital of Foshan (The Affiliated Hospital at Foshan, Southern Medical University), Foshan, China
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Sánchez RA, Boggia J, Peñaherrera E, Barroso WS, Barbosa E, Villar R, Cobos L, Hernández Hernández R, Lopez J, Octavio JA, Parra Carrillo JZ, Ramírez AJ, Parati G. Ambulatory blood pressure monitoring over 24 h: A Latin American Society of Hypertension position paper-accessibility, clinical use and cost effectiveness of ABPM in Latin America in year 2020. J Clin Hypertens (Greenwich) 2020; 22:527-543. [PMID: 32049441 PMCID: PMC8030035 DOI: 10.1111/jch.13816] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/12/2022]
Abstract
Accurate office blood pressure measurement remains crucial in the diagnosis and management of hypertension worldwide, including Latin America (LA). Office blood pressure (OBP) measurement is still the leading technique in LA for screening and diagnosis of hypertension, monitoring of treatment, and long-term follow-up. Despite this, due to the increasing awareness of the limitations affecting OBP and to the accumulating evidence on the importance of ambulatory BP monitoring (ABPM), as a complement of OBP in the clinical approach to the hypertensive patient, a progressively greater attention has been paid worldwide to the information on daytime and nighttime BP patterns offered by 24-h ABPM in the diagnostic, prognostic, and therapeutic management of hypertension. In LA countries, most of the Scientific Societies of Hypertension and/or Cardiology have issued guidelines for hypertension care, and most of them include a special section on ABPM. Also, full guidelines on ABPM are available. However, despite the available evidence on the advantages of ABPM for the diagnosis and management of hypertension in LA, availability of ABPM is often restricted to cities with large population, and access to this technology by lower-income patients is sometimes limited by its excessive cost. The authors hope that this document might stimulate health authorities in each LA Country, as well as in other countries in the world, to regulate ABPM access and to widen the range of patients able to access the benefits of this technique.
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Affiliation(s)
- Ramiro A. Sánchez
- Arterial Hypertension and Metabolic UnitUniversity Hospital, Favaloro, FoundationBuenos AiresArgentina
| | - José Boggia
- Unidad de HipertensiónCentro de NefrologíaHospital Dr. Manuel QuintelaUniversidad de la RepúblicaMontevideoUruguay
| | | | | | - Eduardo Barbosa
- Hypertension League Hospital San FranciscoComplexo Ermandade Santa Casa de Porto AlegrePorto AlegreBrazil
| | | | | | - Rafael Hernández Hernández
- Hypertension and Cardiovascular Risk Factors ClinicSchool of MedicineUniversidad Centro Occidental Lisandro AlvaradoBarquisimetoVenezuela
| | - Jesús Lopez
- Unidad de Hipertension ArterialHospital Universitario Dr. Jose M. VargasSan CristobalTachiraVenezuela
| | - José Andrés Octavio
- Department of Experimental CardiologyTropical Medicine InstituteUniversidad Central de VenezuelaCaracasVenezuela
| | | | - Agustín J. Ramírez
- Arterial Hypertension and Metabolic UnitUniversity Hospital, Favaloro, FoundationBuenos AiresArgentina
| | - Gianfranco Parati
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaMilanItaly
- Cardiology UnitIstituto Auxologico ItalianoIRCCSSan Luca HospitalMilanItaly
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Nsutebu NS, Owusu IK, Buabeng KO, Bonsu KO. Ambulatory blood pressure monitoring and management of hypertension at a cardiac clinic in Kumasi Metropolis, Ghana. J Clin Hypertens (Greenwich) 2020; 22:605-613. [PMID: 32049428 PMCID: PMC8029742 DOI: 10.1111/jch.13822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/29/2019] [Accepted: 12/10/2019] [Indexed: 11/28/2022]
Abstract
Ambulatory blood pressure monitoring (ABPM) is considered a good intervention strategy to avoid misdiagnosis of hypertension and allow for targeted treatment of patients with hypertension. This study sought to assess the contribution of ABPM to blood pressure (BP) control and antihypertensive therapy at a cardiac clinic in Ghana. Medical records of 97 patients, aged 18-85 years (mean 55), were reviewed. Among patients with clinic BP (CBP) and ambulatory BP recorded on the same day, we assessed for the different hypertension phenotypes, CBP control 6 months following ABPM, and changes to antihypertensive therapy after review of the ABPM records in patients with controlled and uncontrolled ambulatory BP. From the clinic and ambulatory BP records measured at baseline, the proportion of patients with white-coat uncontrolled hypertension (WUCH) was 19.5% (17/87) and those with masked uncontrolled hypertension (MUCH) was 16.1% (n = 14). A significant reduction in average systolic CBP in the overall cohort (-6.2 mm Hg, P < .01) and in the uncontrolled subgroup (-8.8 mm Hg, P < .001) at follow-up was observed. After review of the ABPM records, 51.7% of the patients on treatment had changes made in their antihypertensive therapy. Antihypertensive therapy was deintensified or left unchanged in majority of the patients with WUCH and sustained controlled hypertension. In patients with MUCH and true uncontrolled hypertension (TUCH), therapy was intensified. In conclusion, ABPM improved clinical decision-making for antihypertensive therapy and BP control. ABPM should therefore be used more often in hypertension and cardiac clinics in low/middle-income countries for optimal care.
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Affiliation(s)
- Ntani Suh Nsutebu
- Department of Pharmacy PracticeFaculty of Pharmacy and Pharmaceutical SciencesCollege of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Isaac Kofi Owusu
- Department of MedicineSchool of Medicine and DentistryCollege of Health ScienceKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Kwame Ohene Buabeng
- Department of Pharmacy PracticeFaculty of Pharmacy and Pharmaceutical SciencesCollege of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Kwadwo Osei Bonsu
- Department of Pharmacy PracticeFaculty of Pharmacy and Pharmaceutical SciencesCollege of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
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Delsart P, Soquet J, Ramdane N, Ramond C, Mugnier A, Rousse N, Ledieu G, Bical A, Loobuyck V, Jegou B, Modine T, Hysi I, Fabre O, Juthier F, Vincentelli A, Mounier-Vehier C. Aortic morphology post type A acute aortic syndrome: Prognosis significance and association with 24-hour blood pressure-monitoring parameters. J Card Surg 2020; 35:981-987. [PMID: 32176383 DOI: 10.1111/jocs.14512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND After an emergent surgery for type A acute aortic syndrome, medical management is based on optimal blood pressure (BP) control. We assessed the prognostic significance of BP monitoring and its relationship with aortic morphology following type A acute aortic syndrome. METHODS The data of 120 patients who underwent BP monitoring after a type A acute aortic syndrome from January 2005 to June 2016 were retrospectively collected. The first CT angiogram performed after surgery was used for the morphological analysis. RESULTS The population included 79 males, with an overall mean age of 60 ± 12 years. Seven patients (5.8%) died during a median follow-up of 5.5 years. The median delay between BP monitoring and discharge was 3 (1-5) months. The mean 24-hour BP of the cohort was 127/73 mm Hg ± 10/17. During follow-up, different parameters of BP monitoring were not associated with the risk of aortic events. However, the diameter of the false lumen of the descending thoracic aorta was the best predictor associated with the risk of new aortic events during follow-up, particularly for the threshold of 28 mm or more (P < .001; Hazard ratio 4.7[2.7-8.2]). The diameter of the false lumen was associated with night-time systolic BP (P = .025; r = .2), 24-hour pulse pressure (P = .002; r = .28), and night-time pulse pressure (P = .008; r = .24). CONCLUSION The risk of new aortic events following type A acute aortic syndrome is associated with the size of the residual false lumen, but not directly with BP parameters. Night-time BP parameters are associated with the size of the residual false lumen.
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Affiliation(s)
| | - Jérôme Soquet
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Nassima Ramdane
- METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, University of Lille, CHU Lille, ULR 2694, Lille, France
| | | | | | - Natacha Rousse
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | | | - Antoine Bical
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Lille, France
| | - Valentin Loobuyck
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Bruno Jegou
- CHU Lille, Institut Cœur Poumon, Lille, France
| | | | - Ilir Hysi
- Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Générale de Santé, Lens, France
| | - Olivier Fabre
- Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Générale de Santé, Lens, France
| | - Francis Juthier
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Andre Vincentelli
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Inserm U1011, Lille, France
| | - Claire Mounier-Vehier
- CHU Lille, Institut Cœur Poumon, Lille, France.,University of Lille, CHU Lille, Lille, France
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Ambulatory Blood Pressure Monitoring in Pregnancy; Does It Influence Our Practice? Nephrourol Mon 2019. [DOI: 10.5812/numonthly.93157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Turner JR. "Assessment of Pressor Effects of Drugs"-A New US FDA Draft Guidance for Industry. Ther Innov Regul Sci 2018; 52:397-399. [PMID: 29996733 DOI: 10.1177/2168479018786478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kim S, Lee JD, Park JB, Jang S, Kim J, Lee SS. Evaluation of the Accuracy of a New Cuffless Magnetoplethysmography Blood Pressure Monitor in Hypertensive Patients. Pulse (Basel) 2018; 6:9-18. [PMID: 30283749 PMCID: PMC6140613 DOI: 10.1159/000484940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/01/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE There is a growing demand for cuffless blood pressure (BP) measurement as an easy alternative to cuff-occlusion-based BP measurement. We assessed the accuracy of a new cuffless, watch-style BP monitor with a magnetoplethysmography (MPG) sensor compared to two standard auscultatory and oscillatory BP monitors. SUBJECTS AND METHODS A total of 34 patients with uncontrolled hypertension (systolic BP ≥150 mm Hg or diastolic BP ≥95 mm Hg) were enrolled in the study. BP was measured by two conventional monitors and the new device during the pre-exercise phase, during isometric handgrip exercise, and during the recovery phase (5 min after exercise). The correlation between monitors was assessed using intraclass correlation coefficient (ICC) and Bland-Altman plots. RESULTS Although two reference monitors produced highly correlated BP measurements, each was differentially correlated with BP measurements obtained by the new MPG monitor. During exercise, the mean difference between systolic BP obtained by the MPG and oscillatory monitors was >7 mm Hg with an ICC of 0.549 (95$ CI 0.264-0.746) in systole and 0.737 (95$ CI 0.534-0.859) in diastole. The ICC between the auscultatory monitor and the MPG monitor was 0.753 (95$ CI 0.559-0.868) in systole and 0.841 (95$ CI 0.706-0.918) in diastole after exercise. Bland-Altman plots also indicated that the performance of the new MPG device was very similar to that of the auscultatory monitor. CONCLUSION Although the performance of the new MPG monitor was comparable to that of the reference monitors used in this study, improved stability and accuracy are necessary for accurate BP evaluation during dynamic activity.
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Affiliation(s)
- Sua Kim
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
| | | | | | - Seungjin Jang
- Intelligence Lab, Convergence Center, LG Electronics, Seoul, Republic of Korea
| | - Jungchae Kim
- Artificial Intelligence Lab, SW Center, LG Electronics, Seoul, Republic of Korea
| | - Sang-Suk Lee
- Department of Oriental Biomedical Engineering, Sangji University, Wonju, Republic of Korea
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Cardiovascular effects of oral appliance therapy in obstructive sleep apnea: A systematic review and meta-analysis. Sleep Med Rev 2017; 40:55-68. [PMID: 29195726 DOI: 10.1016/j.smrv.2017.10.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/10/2017] [Accepted: 10/18/2017] [Indexed: 11/24/2022]
Abstract
Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. This study systematically reviews the effects of oral appliance therapy (OAT) on a broad spectrum of cardiovascular outcomes. A literature search was performed up to December 31st 2016. Twenty-five relevant full-text articles were retrieved. Sixteen articles were considered methodologically sufficient, including 11 randomized controlled trials. Pooled data of the RCTs showed significant reductions in daytime systolic and diastolic blood pressure compared to baseline, but no significant reductions in heart rate, except for daytime heart rate when compared to inactive/placebo OAT. OAT and continuous positive airway pressure (CPAP) were equally effective in reducing blood pressure. Studies assessing the effect of OAT on heart rate variability, circulating cardiovascular biomarkers, and endothelial function and arterial stiffness, generally involved small numbers of patients, and were heterogeneous and inconclusive. Studies assessing the effect of OAT on cardiac function showed no effects on echocardiographic outcomes. One observational study showed that OAT was as effective as CPAP in reducing cardiovascular death. It could be speculated that OAT may lead to a reduction in long-term cardiovascular morbidity and mortality in OSA patients. However, further methodologically high quality, longitudinal studies are warranted to address this key question.
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