Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPFATURETO-BORGES, FernandaLORENZI-FILHO, GeraldoDRAGER, Luciano F.2016-10-172016-10-172016INTEGRATED BLOOD PRESSURE CONTROL, v.9, p.43-47, 20161178-7104https://observatorio.fm.usp.br/handle/OPI/16113Obstructive sleep apnea (OSA) is an extremely common comorbid condition in patients with hypertension, with a prevalence of similar to 50%. There is growing evidence suggesting that OSA is a secondary cause of hypertension, associated with both poor blood pressure (BP) control and target organ damage in patients with hypertension. The application of continuous positive airway pressure (CPAP) during sleep is the gold standard treatment of moderate-to-severe OSA and very effective in abolishing obstructive respiratory events. However, several meta-analyses showed that the overall impact of CPAP on BP is modest (similar to 2 mmHg). There are several potential reasons for this disappointing finding, including the heterogeneity of patients studied (normotensive patients, controlled, and uncontrolled patients with hypertension), non-ideal CPAP compliance, clinical presentation (there is some evidence that the positive impact of CPAP on lowering BP is more evident in sleepy patients), and the multifactorial nature of hypertension. In this review, we performed a critical analysis of the literature evaluating the impact of CPAP on BP in several subgroups of patients. We finally discussed perspectives in this important research area, including the urgent need to identify predictors of BP response to CPAP and the importance of precision medicine in this scenario.engopenAccesscardiovascular diseaseCPAPhypertensionsleep apneatreatmentrandomized controlled-trialplacebo-controlled trialresistant hypertensionmasked hypertensionsystemic hypertensionarterial stiffnessclinical-trialriskcpapbparticleCopyright DOVE MEDICAL PRESS LTD10.2147/IBPC.S70402Peripheral Vascular Disease