Evidence map›Paper›PMID 24947425›Full record

SynthesisThorax2014

Effect of CPAP on blood pressure in patients with minimally symptomatic obstructive sleep apnoea: a meta-analysis using individual patient data from four randomised controlled trials.

Daniel J Bratton, John R Stradling, Ferran Barbé, Malcolm Kohler

Registry-linked trialOpen access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Thorax, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03432390 (Continuous Positive Airway Pressure During General Anesthesia Induction For Elective Pediatric Surgery), which is not on this map. Cited by 65 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 3 pooled it
10.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03432390 nacompletednot on this mapstarted 2018, after this paper: background citation

Continuous Positive Airway Pressure During General Anesthesia Induction For Elective Pediatric Surgery: Randomized Clinical Trial

TypeinterventionalSponsorInstituto Materno Infantil Prof. Fernando FigueiraRan2018 to 2019Enrolled72ConditionsContinuous Positive Airway Pressure, Hypoxia, General AnesthesiaArmsContinuous Positive Airway Pressure, Open system ventilation
3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 3 syntheses or guidelines pooled it, 180 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Review
  9. Observational
  10. Review
  11. Review
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Article

5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 3 countries.

Daniel J BrattonMedical Research Council Clinical Trials Unit at University College London, London, UK.
John R StradlingOxford Centre for Respiratory Medicine and NIHR Biomedical Research Centre, Oxford University, Oxford, UK.
Ferran BarbéDepartment of Pneumology, Biomedical Research Institute IRB Lleida and CIBERES, Madrid, Spain.
Malcolm KohlerDivision of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Biomedical Research Institute of Lleida · ESOxford BioMedica (United Kingdom) · GBUniversity College London · GBUniversity Hospital of Zurich · CH

Funding

British Heart Foundation PG/05/068/19057
6 · The paper itself

Abstract

backgroundCPAP reduces blood pressure (BP) in patients with symptomatic obstructive sleep apnoea (OSA). Whether the same benefit is present in patients with minimally symptomatic OSA is unclear, thus a meta-analysis of existing trial data is required.

methodsThe electronic databases Medline, Embase and trial registries were searched. Trials were eligible if they included patients with minimally symptomatic OSA, had randomised them to receive CPAP or either sham-CPAP or no CPAP, and recorded BP at baseline and follow-up. Individual participant data were obtained. Primary outcomes were absolute change in systolic and diastolic BP.

findingsFive eligible trials were found (1219 patients) from which data from four studies (1206 patients) were obtained. Mean (SD) baseline systolic and diastolic BP across all four studies was 131.2 (15.8) mm Hg and 80.9 (10.4) mm Hg, respectively. There was a slight increase in systolic BP of 1.1 mm Hg (95% CI -0.2 to 2.3, p=0.086) and a slight reduction in diastolic BP of 0.8 mm Hg (95% CI -1.6 to 0.1, p=0.083), although the results were not statistically significant. There was some evidence of an increase in systolic BP in patients using CPAP <4 h/night (1.5 mm Hg, 95% CI -0.0 to 3.1, p=0.052) and reduction in diastolic BP in patients using CPAP >4 h/night (-1.4 mm Hg, 95% CI -2.5 to -0.4, p=0.008). CPAP treatment reduced both subjective sleepiness (p<0.001) and OSA severity (p<0.001).

interpretationAlthough CPAP treatment reduces OSA severity and sleepiness, it seems not to have a beneficial effect on BP in patients with minimally symptomatic OSA, except in patients who used CPAP for >4 h/night.

Indexed as

Blood PressureContinuous Positive Airway PressureHumansRandomized Controlled Trials as TopicSleep Apnea, ObstructiveSleep Apnoea

Identifiers

PMID24947425
PMCPMC4251445
OpenAlexW2160441724

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.