To the best of our knowledge, this is the first RCT to address the effect of CPAP therapy on the blood pressure values and metabolic profile in a large cohort of women with moderate-to-severe OSA. We have found that, compared with conservative treatment, 12 weeks of CPAP therapy reduces blood pressure measures, especially diastolic blood pressure, and that this decrease is within the range reported in other large RCTs conducted in predominantly male hypertensive cohorts. Moreover, this improvement may be larger in some subgroups of women, particularly those with daytime sleepiness. 12 weeks of CPAP therapy did not, however, change the glucose and lipid profile of this sample.
Although there is growing and compelling evidence that shows a beneficial effect of CPAP on blood pressure in hypertensive patients with OSA, all this research was conducted in predominantly or exclusively male cohorts where women were underrepresented. One very recent meta-analysis of seven studies with a total of 794 patients reported that all the trials predominantly recruited male patients, with a mean percentage of 74% male. Similarly, the effect of CPAP on glucose and lipid metabolism has also been assessed in cohorts in which women usually accounted for <30–40% of the whole sample. Given that OSA differs between women and men, it cannot be taken for granted that the findings obtained in males can be translated to women. In fact, women may have a different cardiovascular risk profile to men, as suggested by studies which have observed that women had more OSA-related endothelial dysfunction, higher levels of high-sensitivity troponin T and a higher risk of incident heart failure or death than men.
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