Mandibular Advancement vs Continuous Positive Airway Pressure (CPAP) for Blood Pressure Reduction in Patients With Obstructive Sleep Apnea
Authors' conclusion
MAD is noninferior to CPAP for reducing 24-hour mean arterial BP in participants with hypertension and increased cardiovascular risk.
Study context
- Population
- Adults aged ≥40 years with hypertension, increased CV risk and moderate-to-severe obstructive sleep apnea (OSA) (apnea-hypopnea index ≥15 events per hour)321 screened by polysomnography
- Participants
- 220 adults
- Comparison
- Mandibular advancement device (MAD) vs CPAP
- Primary endpoint
- Change in 24-hour mean arterial BP from baseline
- Follow-up
- 6 months
Methodological detailsinvestigator-initiated, non-inferiority, 3 public hospitals
- Investigator-initiated
- Non-inferiority
- 3 public hospitals
Primary result
As reported in the abstract
Change in 24-h mean arterial BP, baseline to 6 months
| Group | Value | P vs baseline | No change from baseline |
|---|---|---|---|
| MAD | decrease from baseline 2.5 mm Hg | P = 0.003 | |
| CPAP | P = 0.374 |
Value
MADdecrease from baseline 2.5 mm Hg
CPAP— not stated in the abstract
P vs baseline
MADP = 0.003
CPAP— not stated in the abstract
No change from baseline
MAD— not stated in the abstract
CPAPP = 0.374
Further findings
Secondary ambulatory blood pressure (BP) parameters
- Larger reduction with MAD vs CPAP in all secondary ambulatory BP parameters, most pronounced in asleep BP
Daytime sleepiness
- Both improved; between-group difference similar
- P = 0.384
CV biomarkers
- No between-group differences
Original publication
Mandibular Advancement vs CPAP for Blood Pressure Reduction in Patients With Obstructive Sleep Apnea. J Am Coll Cardiol. Published 6 April 2024. doi:10.
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