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Impact of Continuous Positive Airway Pressure on Cardiovascular Risk Factors in High-Risk Patients

  • Clinical Trials and Their Interpretations (J Kizer, Section Editor)
  • Published:
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Abstract

Cardiovascular disease remains the leading cause of morbidity and mortality in developed countries. Obstructive sleep apnea is a highly prevalent condition characterized by repetitive upper airway collapse during sleep. A large body of evidence suggests that obstructive sleep apnea is associated with the development of cardiovascular disease and increased cardiovascular morbidity and mortality. Continuous positive airway pressure (CPAP) is the current gold standard for the treatment of obstructive sleep apnea. CPAP devices maintain upper airway patency using a pneumatic splint, thereby ameliorating the repetitive deoxygenation and reoxygenation characteristic of sleep in obstructive sleep apnea patients. Accumulating evidence suggests that CPAP treatment may lead to a reduction in blood pressure. Limited evidence also suggests that CPAP therapy may modulate glucose metabolism, serum cholesterol levels, and inflammatory biomarkers. Thus, CPAP treatment may be associated with cardiovascular risk factor modification in patients with obstructive sleep apnea, who are often obese and at an increased risk of developing cardiovascular disease. This review updates the knowledge on the effects of CPAP on cardiovascular risk factors from recently published randomized trials.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. World Health Organization; World Heart Federation; World Stroke Organization. Global Atlas on cardiovascular disease prevention and control. France: WHO; 2011.

  2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2013 update: a report form the American Heart Association. Circulation. 2013;127:e6–245.

    Article  PubMed  Google Scholar 

  3. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011;94:31–21.

    Article  Google Scholar 

  4. Mozaffarian D, Benjamin E, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2015 update. A report from the American heart association. Circulation. 2015;131(4):e29–322.

    Article  PubMed  Google Scholar 

  5. Peppard PE, Young T, Barnet JH, Barnet JH, Palta M, Hagen EW, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177:1006–14. This study highlights the increasing prevalence of sleep-disordered breathing in the U.S.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, et al. Sleep apnea and cardiovascular disease: an American heart association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. Circulation. 2008;118:1080–111.

    Article  PubMed  Google Scholar 

  7. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342:1378–84.

    Article  CAS  PubMed  Google Scholar 

  8. Bakker JP, Edwards BA, Gautam SP, Montesi SB, Durán-Cantolla J, Barandiaran FA, et al. Blood pressure improvement with continuous positive airway pressure is independent of obstructive sleep apnea severity. J Clin Sleep Med. 2014;10(4):365–9.

    PubMed Central  PubMed  Google Scholar 

  9. Montesi SB, Edwards BA, Malhotra A, Bakker JP. The effect of continuous positive airway pressure treatment on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med. 2012;8(5):587–96.

    PubMed Central  PubMed  Google Scholar 

  10. Nadeem R, Singh M, Nida M, Kwon S, Sajid H, Witkowski J, et al. Effect of CPAP treatment for obstructive sleep apnea hypopnea syndrome on lipid profile: a meta-regression analysis. J Clin Sleep Med. 2014;10(12):1295–302.

    PubMed Central  PubMed  Google Scholar 

  11. Feng Y, Zhang Z, Dong Z. Effects of continuous positive airway pressure therapy on glycaemic control, insulin sensitivity and body mass index in patients with obstructive sleep apnoea and type 2 diabetes: a systematic review and meta-analysis. NPJ Prim Care Respir Med. 2015;25:15006. doi:10.1038/npjpcrm.2015.5.

    Google Scholar 

  12. Drager LF, Brunoni AR, Jenner R, Lorenzi-Filho G, Bensenor IM, Lotufo PA. Effects of CPAP on body weight in patients with obstructive sleep apnoea: a meta-analysis of randomised trials. Thorax. 2015;70:258–64.

    Article  PubMed  Google Scholar 

  13. Nadeem R, Molnar J, Madbouly EM, Nida M, Aggarwal S, Sajid H, et al. Serum inflammatory markers in obstructive sleep apnea: a meta-analysis. J Clin Sleep Med. 2013;9(10):1003–12.

    PubMed Central  PubMed  Google Scholar 

  14. World Health Organization. A global brief on hypertension: silent killer, global public health crisis. Geneva: World Health Organization; 2013.

  15. James PA, Oparil S, Carter B, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults. Report from the panel members appointed to the eighth joint national committee (JNC 8). JAMA. 2014;311(5):507–20.

    Article  CAS  PubMed  Google Scholar 

  16. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo, Jr JL, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; The JNC 7 Report. JAMA. 2003;289(19):2560–71.

  17. Parati G, Lombardi C, Hedner J, Bonsignore MR, Grote L, Tkacova R, et al. Position paper on the management of patients with obstructive sleep apnea and hypertension: joint recommendations by the European Society of Hypertension, by the European Respiratory Society and by the members of European COST (Cooperation in Scientific and Technological Research) ACTION B26 on obstructive sleep apnea. J Hypertens. 2012;30:633–46. This position paper is the only guideline on the management of patients with obstructive airway disease and hypertension.

    Article  CAS  PubMed  Google Scholar 

  18. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. ESH scientific council; ESC committee for practice guidelines. 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European society of cardiology (ESC). Eur Heart J. 2013;34(28):2159–219.

    Article  PubMed  Google Scholar 

  19. Wolf J, Hering D, Narkiewicz K. Non-dipping pattern of hypertension and obstructive sleep apnea syndrome. Hypertens Res. 2010;33(9):867–71.

    Article  PubMed  Google Scholar 

  20. Ben-Dov IZ, Kark JD, Ben-Ishay D, Mekler J, Ben-Arie L, Bursztyn M. Predictors of all-cause mortality in clinical ambulatory monitoring: unique aspects of blood pressure during sleep. Hypertension. 2007;49:1235–41.

    Article  CAS  PubMed  Google Scholar 

  21. Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet. 2002;359:204–11.

    Article  PubMed  Google Scholar 

  22. Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation. 2003;107:68–73.

    Article  PubMed  Google Scholar 

  23. Norman D, Loredo JS, Nelesen RA, Ancoli-Israel S, Mills PJ, Ziegler MG, et al. Effects of continuous positive airway pressure versus supplemental oxygen on 24-h ambulatory blood pressure. Hypertension. 2006;47:840–5.

    Article  CAS  PubMed  Google Scholar 

  24. Lozano L, Tovar JL, Sampol G, Romero O, Jurado MJ, Segarra A, et al. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. J Hypertens. 2010;28:2161–8.

    Article  CAS  PubMed  Google Scholar 

  25. Pedrosa RP, Drager LF, de Paula LKG, Amaro ACS, Bortolotto LA, Lorenzi-Filho G. Effects of OSA treatment on BP in patients with resistant hypertension: a randomized trial. Chest. 2013;144:1487–94.

    Article  CAS  PubMed  Google Scholar 

  26. Barbé F, Mayoralas LR, Duran J, Masa JF, Maimó A, Montserrat JM, et al. Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness: a randomized, controlled trial. Ann Intern Med. 2001;134:1015–23.

    Article  PubMed  Google Scholar 

  27. Barnes M, McEvoy RD, Banks S, Tarquinio N, Murray CG, Vowles N, et al. Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med. 2004;170:656–64.

    Article  PubMed  Google Scholar 

  28. Campos-Rodriguez F, Grilo-Reina A, Perez-Ronchel J, Merino-Sanchez M, Gonzalez-Benitez MA, Beltran-Robles M, et al. Effect of continuous positive airway pressure on ambulatory BP in patients with sleep apnea and hypertension: a placebo-controlled trial. Chest. 2006;129:1459–67.

    Article  PubMed  Google Scholar 

  29. Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, Martinez-Alonso M, Carmona C, Barcelo A, et al. Spanish sleep and breathing network. Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA. 2012;307:2161–8. One of the largest multicenter randomized controlled trials of the effect of continuous positive airway pressure (CPAP) on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea (OSA). The authors found that among n=723 nonsleepy patients with OSA, the use of CPAP compared to usual care did not result in a statistically significant reduction in the incidence of hypertension or cardiovascular events during a median follow-up of 4 years.

  30. Haentjens P, Van Meerhaeghe A, Moscariello A, De Weerdt S, Poppe K, Dupont A, et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med. 2007;167:757–64.

    Article  PubMed  Google Scholar 

  31. Bazzano LA, Khan Z, Reynolds K, He J. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension. 2007;50:417–23.

    Article  CAS  PubMed  Google Scholar 

  32. Alajmi M, Mulgrew AT, Fox J, Davidson W, Schulzer M, Mak E, et al. Impact of continuous positive airway pressure therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung. 2007;185:67–72.

    Article  CAS  PubMed  Google Scholar 

  33. Fava C, Dorigoni S, Dalle Vedove F, Danese E, Montagnana M, Guidi GC, et al. Effect of CPAP on blood pressure in patients with OSA/hypopnea. A systematic review and meta-analysis. Chest. 2014;145(4):762–71.

    Article  PubMed  Google Scholar 

  34. Schein ASO, Kerkhoff AC, Coronel CC, Plentz RDM, Sbruzzi G. Continuous positive airway pressure reduces blood pressure in patients with obstructive sleep apnea; a systematic review and meta-analysis with 1000 patients. J Hypertens. 2014;32:1762–73. A recent meta-analysis of sixteen randomized controlled trials that investigated patients with obstructive sleep apnea (OSA) treated with continuous positive airway pressure (CPAP) compared with placebo CPAP, sham CPAP or subtherapeutic CPAP found that treatment with CPAP resulted in a small but statistically significant reduction in blood pressure (office systolic and diastolic blood pressure, night-time systolic blood pressure and mean blood pressure, and 24-h diastolic and mean blood pressure) in individuals with OSA.

    Article  CAS  PubMed  Google Scholar 

  35. Hu X, Fan J, Chen S, Yin Y, Zrenner B. The role of continuous positive airway pressure in blood pressure control for patients with obstructive sleep apnea and hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens Greenwich. 2015;17:215–22.

    Article  PubMed  Google Scholar 

  36. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–13.

    Article  PubMed  Google Scholar 

  37. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomized trials in the context of expectations from prospective epidemiological studies. BMJ. 2009;338:b1665.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Bratton DJ, Stradling JR, Barbé F, Kohler M. Effect of CPAP on blood pressure in patients with minimally symptomatic obstructive sleep apnoea: a meta-analysis using individual patients data from four randomized controlled trials. Thorax. 2014;69:1128–35. A meta-analysis of five trials investigating the effect of continuous positive airway pressure (CPAP) on blood pressure (BP) in patients with minimally symptomatic obstructive sleep apnea found that CPAP did not have a benefiical effect on BP, except for a small reduction in diastolic BP in patients using CPAP >4 h/night.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Martinez-Garcia MA, Gomez-Aldaravi R, Soler-Cataluna JJ, Martinez TG, Bernacer-Alpera B, Roman-Sancez P. Positive effect of CPAP treatment on the control of difficult-to-treat hypertension. Eur Respir J. 2007;29(5):951–7.

    Article  CAS  PubMed  Google Scholar 

  40. Gottlieb DJ, Punjabi NM, Mehra R, Patel SR, Quan SF, Babineau DC, et al. CPAP versus oxygen in obstructive sleep apnea. N Engl J Med. 2014;370(24):2276–85. In this randomized controlled trial, treatment of moderate to severe obstructive sleep apnea in patients with cardiovascular disease or multiple cardiovascular risk factors with continuous positive airway pressure led to a significant reduction in 24-h mean blood pressure compared to the control group or the group receiving supplemental nocturnal oxygen.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Chirinos JA, Gurubhagavatula I, Teff K, Rader DJ, Wadden TA, Townsend R, et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med. 2014;370(24):2265–75.

    Article  PubMed Central  PubMed  Google Scholar 

  42. McMillan A, Bratton DJ, Faria R, Laskawiec-Szkonter M, Griffin S, Davies RJ, et al. Continuous positive airway pressure in older people with obstructive sleep apnoea syndrome (PREDICT): a 12-month, multicentre, randomised trial. Lancet Respir Med. 2014;2(10):804–12.

    Article  PubMed  Google Scholar 

  43. Logan AG, Perlikowski SM, Mente A, Tisler A, Tkacova R, Niroumand M, et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens. 2001;19(12):2271–7.

    Article  CAS  PubMed  Google Scholar 

  44. Lozano L, Tovar JL, Sampol G, Romero O, Jurado MJ, Segarra A, et al. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. J Hypertens. 2010;28(10):2161–8.

    Article  CAS  PubMed  Google Scholar 

  45. Dernaika TA, Kinasewitz GT, Tawk MM. Effects of nocturnal continuous positive airway pressure therapy in patients with resistant hypretension and obstructive sleep apnea. J Clin Sleep Med. 2009;5(2):103–7.

    PubMed Central  PubMed  Google Scholar 

  46. Martinez-Garcia MA, Capote F, Campos-Rodriguez F, Lloberes P, de Atauri MJ D, Somoza M, et al. Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: the HIPARCO randomized clinical trial. JAMA. 2013;310(22):2407–15. The HIPARCO trial found that CPAP treatment compared with control resulted in a significant decrease in 24-h mean and diastolic blood pressure and an improvement in the nocturnal blood pressure pattern among patients with obstructive sleep apnea and resistant hypertension.

    Article  CAS  PubMed  Google Scholar 

  47. Lloberes P, Sampol G, Espinel E, Segarra A, Ramon MA, Romero O, et al. A randomized controlled study of CPAP effect on plasma aldosterone concentration in patients with resistant hypertension and obstructive sleep apnea. J Hypertens. 2014;32:1650–7.

    Article  CAS  PubMed  Google Scholar 

  48. De Oliveira AC, Martinez D, Massierer D, Gus M, Goncalves SC, Ghizzoni F, et al. The antihypertensive effect of positive airway pressure on resistant hypertension of patients with obstructive sleep apnea: a randomized, double-blind, clinical trial. Am J Respir Crit Care Med. 2014;190(3):345–7.

    Article  PubMed  Google Scholar 

  49. Muxfeldt ES, Margallo V, Costa LMS, Guimaraes G, Cavalcante AH, Azevedo JCM, et al. Effects of continuous positive airway pressure treatment on clinic and ambulatory blood pressures in patients with obstructive sleep apnea and resistant hypertension. A randomized controlled trial. Hypertension. 2015;65:736–42. In this randomized controlled trial, CPAP treatment for 6 months had no significant effect on clinic and ambulatory blood pressures in patients with resistant hypertension and moderate to severe obstructive sleep apnea. The greatest benefit (albeit not statistically significant) was observed on night-time systolic blood pressure and on nocturnal blood pressure fall.

    Article  CAS  PubMed  Google Scholar 

  50. Huang Z, Liu Z, Luo Q, Zhao Q, Zhao Z, Ma X, et al. Long-term effects of continuous positive airway pressure on blood pressure and prognosis in hypertensive patients with coronary heart disease and obstructive sleep apnea: a randomized controlled trial. Am J Hypertens. 2015;28(3):300–6.

    Article  PubMed  Google Scholar 

  51. Center for Disease Control (CDC). National diabetes fact sheet, 2011. Atlanta: Department of Health and Human Services, Center for Disease Control and Prevention; 2011.

    Google Scholar 

  52. Pamidi S, Tasali E. Obstructive sleep apnea and type 2 diabetes: is there a link? Front Neurol. 2012;3:126.

    Article  PubMed Central  PubMed  Google Scholar 

  53. Iftikhar IH, Hoyos CM, Phillips CL, Magalang UJ. Meta-analyses of the association of sleep apnea with insulin resistance, and the effects of CPAP on HOMA_IR, adiponectin, and visceral adipose fat. J CLin Sleep Med. 2014; Dec 6. Pii:jc-00182-14.

  54. Weinstock TG, Wang X, Rueschman M, Ismail-Beigi F, Aylor J, Babineau DC, et al. A controlled trial of CPAP therapy on metabolic control in individuals with impaired glucose tolerance and sleep apnea. Sleep. 2012;35(5):617–25B.

    PubMed Central  PubMed  Google Scholar 

  55. Drager LF, Jun JC, Polotsky VY. Metabolic consequences of intermittent hypoxia: relevance to obstructive sleep apnea. Best Pract Res Clin Endocrinol Metab. 2010;24(5):843–51.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  56. Mirrakhimov AE, Ali AM. Pathobiology of obstructive sleep apnea-related dyslipidemia: focus on the liver. ISRN Cardiology. 2013;687069. doi:10.1155/2013/687069.

  57. Lin MT, Lin HH, Lee PL, Weng PH, Lee CC, Lai TC, et al. Beneficial effect of continuous positive airway pressure on lipid profiles in obstructive sleep apnea: a meta-analysis. Sleep Breath. 2014.

  58. Xu H, Yi H, Guan J, Yin S. Effect of continuous positive airway pressure on lipid profile in patients with obstructive sleep apnea syndrome: a meta-analysis of randomized controlled trials. Atherosclerosis. 2014;234:446–53.

    Article  CAS  PubMed  Google Scholar 

  59. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes Lond. 2008;32(9):1431–7.

    Article  CAS  PubMed  Google Scholar 

  60. Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA. 2000;284:3015–21.

    Article  CAS  PubMed  Google Scholar 

  61. Quan SF, Budhiraja R, Clarke DP, Goodwin JL, Gottlieb DJ, Nichols DA, et al. Impact of treatment with continuous positive airway pressure (CPAP) on weight in obstructive sleep apnea. J Clin Sleep Med. 2013;9:989–93.

    PubMed Central  PubMed  Google Scholar 

  62. Redenius R, Murphy C, O’Neill E, Al-Hamwi M, Zallek SN. Does CPAP lead to change in BMI? J Clin Sleep Med. 2008;4:205.

    PubMed Central  PubMed  Google Scholar 

  63. Garcia JM, Sharafkhaneh H, Hirshkowitz M, Elkhatib R, Sharafkhaneh A. Weight and metabolic effects of CPAP in obstructive sleep apnea patients with obesity. Respir Res. 2011;12:80.

    Article  PubMed Central  PubMed  Google Scholar 

  64. Batool-Anwar S, Goodwin JL, Drescher AA, Baldwin CM, Simon RD, Smith TW, et al. Impact of CPAP on activity patterns and diet in patients with obstructive sleep apnea (OSA). J Clin Sleep Med. 2014;10(5):465–72.

    PubMed Central  PubMed  Google Scholar 

  65. Xie X, Pan L, Ren D, Du C, Guo Y. Effect of continuous positive airway pressure therapy on systemic inflammation in obstructive sleep apnea: a meta-analysis. Sleep Med. 2013;14(11):1139–50.

    Article  PubMed  Google Scholar 

  66. Baessler A, Nadeem R, Harvey M, Madbouly E, Younus A, Sajid H, et al. Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers—a meta-analysis. J Inflamm Lond. 2013;10:13.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  67. Ridker PM. C-reactive protein and the prediction of cardiovascular events among those at intermediate risk. J Am Coll Cardiol. 2007;49(21):2129–38.

    Article  CAS  PubMed  Google Scholar 

  68. Guo Y, Pan L, Ren D, Xie X. Impact of continuous positive airway pressure on C-reactive protein in patients with obstructive sleep apnea: a meta-analysis. Sleep Breath. 2013;17(2):495–503.

    Article  PubMed  Google Scholar 

  69. Friedman M, Samuelson CG, Hamilton C, Fisher M, Kelley K, Joseph NJ, et al. Effect of continuous positive airway pressure on C-reactive protein levels in sleep apnea: a meta-analysis. Otolaryngol Head Neck Surg. 2012;147(3):423–33.

    Article  PubMed  Google Scholar 

  70. Kostopoulos K, Alhanatis E, Pampoukas K, Georgiopoulos G, Zouria A, Panoutsopoulos A, et al. CPAP therapy induces favorable short-term changes in epicardial fat thickness and vascular and metabolic markers in apparently healthy subjects with obstructive sleep apnea-hypoapnea syndrome (OSAHS). Sleep Breath. 2015.

  71. Sharma SK, Mishra HK, Sharma H, Goel A, Sreenivas V, Gulati V, et al. Obesity, and not obstructive sleep apnea, is responsible for increased serum hs-CRP levels in patients with sleep-disordered breathing in Delhi. Sleep Med. 2008;9(2):149–56.

    Article  CAS  PubMed  Google Scholar 

  72. Julian-Desayes I, Joyeux-Faure M, Tamisier R, Launois S, Borel AL, Levey P, et al. Impact of obstructive sleep apnea treatment by continuous positive airway pressure on cardiometabolic biomarkers: a systematic review from sham CPAP randomized controlled trials. Sleep Med Rev. 2015;21:23–38. doi:10.1016/j.smrv.2014.07.004. This paper provides a systematic review of the evidence from randomized controlled trials addressing the impact of continuous positive airway pressure on cardiometabolic biomarkers.

  73. Stradling JR, Craig SE, Kohler M, Nicoll D, Ayers L, Nunn AJ, et al. Markers of inflammation: data from the MOSAIC randomised trial of CPAP for minimally symptomatic OSA. Thorax. 2015;70(2):181–2. doi:10.1136/thoraxjnl-2014-205958.

    Article  CAS  PubMed  Google Scholar 

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Conflict of Interest

Ying Y. Zhao declares no conflict of interest.

Susan Redline has received NIH/NHLBI grants and is a site principle investigator in a phase III trial sponsored by the Jazz Pharmaceuticals.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, BLI 225, Boston, MA, 02115, USA

    Ying Y. Zhao & Susan Redline

  2. Beth Israel Deaconess Medical Center, Boston, MA, USA

    Susan Redline

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  1. Ying Y. Zhao
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Correspondence to Ying Y. Zhao.

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Zhao, Y.Y., Redline, S. Impact of Continuous Positive Airway Pressure on Cardiovascular Risk Factors in High-Risk Patients. Curr Atheroscler Rep 17, 62 (2015). https://doi.org/10.1007/s11883-015-0540-7

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