What is the effectiveness of CPAP treatment on primary stroke prevention?
No randomized trial has evaluated the effectiveness of CPAP on primary stroke prevention. The existing longitudinal cohort data indicate that CPAP treatment is associated with a reduction in cardiovascular risk among patients with sleep apnea compared with patients who are not treated with CPAP even after adjustment for vascular risk factors and that this finding is most robust for patients with the most severe sleep apnea.737 739 For example, a study of 264 healthy subjects, 403 untreated patients with sleep apnea, and 372 patients with CPAP treatment for 10 years739 had a combined vascular event end point that included fatal or non- fatal stroke or MI or acute coronary syndrome requiring car- diac intervention. 