{"id":"b229eef7de1a","type":"article","url":"https://hartvaat.nl/2026/10/01/cpap-therapie-verlaagt-diastolische-bloeddruk-bij-niet-slaapige-osa-systematisch/","title":"CPAP-therapie verlaagt diastolische bloeddruk bij niet-slaapige OSA — systematische review","title_en":"Does treatment of nonsleepy OSA with CPAP therapy change CVD risk? A systematic review.","category":"preventie","category_label":"Preventie","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Sleep medicine","doi":"10.1016/j.sleep.2026.109093","source_url":"https://doi.org/10.1016/j.sleep.2026.109093","authors":["Kiran Abraham-Aggarwal","Christie Hung","Xiaoxuan Chen","Shriya Suresh","Meghana Ramineni","Ashutosh Kacker"],"significance":5,"published":"2026-07-27","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/obstructief-slaapapneu-en-hart/","https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/"],"congress":"","summary_en":"A PRISMA-guided systematic review of 11 randomized trials evaluated the cardiovascular impact of CPAP therapy in adults with non-sleepy obstructive sleep apnea (OSA). Pooled analysis demonstrated a significant reduction in diastolic blood pressure by 2.33 mmHg, whereas systolic blood pressure and hard cardiovascular endpoints showed no significant benefit. For clinical practice, this suggests CPAP offers only a modest effect on diastolic pressure in this population, highlighting the need for longer follow-up and standardized endpoints to confirm hard cardiovascular outcomes.","created":"2026-07-20T00:54:49Z","updated":"2026-08-10T10:38:23Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een PRISMA-systematische review van elf RCT’s onderzocht de cardiovasculaire effecten van CPAP-therapie bij volwassenen met niet-slaapige obstructieve slaapapneu (OSA). De gepoolde analyse toonde een significante daling van de diastolische bloeddruk met 2,33 mmHg, terwijl de systolische bloeddruk en harde cardiovasculaire endpoints niet significant verbeterden. Voor de dagelijkse praktijk betekent dit dat CPAP bij deze patiëntengroep vooral een bescheiden effect heeft op de diastolische druk, en dat langere follow-up en gestandaardiseerde eindpunten nodig zijn om harde CVD-voordelen vast te stellen.","abstract_original":"BACKGROUND: Nonsleepy obstructive sleep apnea (OSA) lacks daytime symptoms yet is associated with elevated cardiovascular risk. Continuous positive airway pressure (CPAP) is standard therapy, but cardiovascular benefits in nonsleepy OSA remain debated. OBJECTIVE: To synthesize evidence on CPAP and cardiovascular outcomes in adults with nonsleepy OSA and quantify blood pressure (BP) effects where data permit. METHODS: We performed a PRISMA-guided systematic review of Embase, PubMed, and Medline from inception through April 10, 2025 (PROSPERO: CRD420250480329). Eligible English-language studies included adults with nonsleepy OSA treated with CPAP and reported cardiovascular outcomes. Random-effects subgroup meta-analyses pooled systolic BP (SBP) and diastolic BP (DBP) from randomized controlled trials (RCTs) with extractable effect estimates. RESULTS: Twelve studies (2006-2024) met inclusion criteria, including 11 RCTs (92%) and one post-hoc analysis (8%), with cohorts predominantly male and obese and comparators of placebo or standard care. All studies assessed BP; five reported marginal or no benefit and six suggested BP reductions, often adherence dependent. Cardiovascular event findings were inconsistent. Only four trials had extractable SBP data and three for DBP. Pooled estimates showed no significant SBP reduction (-0.42 mmHg; 95% CI -3.52 to 2.68; p = 0.69; I2 = 62%) but a significant DBP reduction (-2.33 mmHg; 95% CI -3.32 to -1.35; p = 0.01; I2 = 0%). CONCLUSIONS: CPAP reduces DBP in pooled RCT data for nonsleepy OSA, while SBP and event-level effects vary. Standardized endpoints, longer follow-up, and comprehensive reporting are needed."}