The Correlation Between OSAHS And Hypertension: A Systematic Review

Objective Use the method of evidence-based medicine: the systematic review to assessthe correlation between OSAHS and hypertension.Methods Define the research subject，formulate the inclusion criterion and theexclusion criterion. In accordance with the inclusion and exclusion criterion, draw up anappropriate search strategy to collect relational literatures. We used computer to search theCochrane Library, MEDLINE (1950~2011.4), EMBASE (1989~2011.4), VIP (1989~2011.4),WANFAN (1977~2011.4), CBM (1978~2011.4), CNKI (1979~2011.4) for published literaturesabout the correlation between OSAHS and hypertension. And we also searched correlativemeeting literatures and other unpublicized articles, and also consulted the experts to get othercorrelated data. Select the literatures according to the inclusion and exclusion criterion, andinclude all cohort studies and case control studies which are about the correlation betweenOSAHS and hypertension. Arrange the included literatures, assess their quality and extractrelated data. Two authors collect literatures and assess the quality of them independently. Use theRevMan5.1.2 to analysis the included literatures, assess the heterogeneity and make respectiveMeta-analysis according to the different type of studies and different grade of OSAHS. Use theGRADE3.6 to assess the quality of evidence.Results We totally searched out 2224 related literatures. The first selected we include 89literatures, the second time we exclude 79 of them. And finally 11 literatures, totally 4019participants were included. In all the included literatures there are only 1 prospective cohortstudies, totally 346 participants. Other 10 literatures are case control studies, totally 3637participants. As the outcome of the heterogeneity analysis, group the included literatures todifferent subgroup. The results of meta-analyses showed that: a) Case control studies vs.prospective cohort study: the META-analysis shows that P=0.16, RR=2.52, 95%CI (2.21, 2.87),the different between the case group and the control group has statistically significant. Thatmeans the OSAHS is correlated with hypertension; b) Mild OSAHS group vs. moderate OSAHSgroup vs. severe OSAHS group: the META-analysis shows that P=0.83, RR=1.84, 95%CI (1.53,2.22), the different between the case group and the control group has statistically significant.That means the correlation between OSAHS and hypertension is related with different grades ofOSHAS. And the more severe OSAHS, the participants are more likely to have hypertension.The“funnel”is asymmetric, means that there might be publication bias. GRADE shows the quality of included literature is“very low”.Conclusions Available evidence suggests that OSAHS is significantly related withhypertension, and may be a risk factor for each other. The correlation between OSAHS andhypertension may be related with different grades of OSAHS: participants may be more likely tohave hypertension if the OSAHS is more severe. The quality of our included literatures is poor;there is a great lack of more and higher quality studies about the correlation between OSAHSand hypertension, especially the prospective cohort studies.