Sleep medicine · Does CPAP prevent cardiovascular events?
Barbe 2012
Effect of CPAP on the incidence of hypertension and cardiovascular events in nonsleepy patients with OSA
Barbe 2012 trial design and results
Design
Randomised controlled trial
Treatment
CPAP
Control
Usual care without CPAP
Population
723 patients with obstructive sleep apnoea and no daytime sleepiness
Follow-up
Median 4 years
Primary endpoint
Incidence of new hypertension or a cardiovascular event
Result
In the CPAP group there were 68 new cases of hypertension and 28 cardiovascular events. The reduction versus usual care was not statistically significant, and the authors noted the study may have been underpowered.
In patients with OSA without daytime sleepiness, the prescription of CPAP compared with usual care did not result in a statistically significant reduction in the incidence of hypertension or cardiovascular events. However, the study may have had limited power to detect a significant difference.
The trial authors, in the published abstract
How it has aged
Concordant with SAVE and subject to the same reading: in patients without sleepiness, CPAP is not established as cardiovascular prevention. The authors' own admission of limited power is the honest caveat, and adherence again dominates any interpretation.
Publications
Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial
Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, et al. Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA 2012 May 23;307(20):2161-8.
No significant reduction in incident hypertension or cardiovascular events
Authors noted the trial may have been underpowered