{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T17:01:24Z","timestamp":1781283684053,"version":"3.54.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To determine whether baseline atherosclerotic cardiovascular disease (ASCVD) modifies the blood pressure (BP) response to mandibular advancement device (MAD) vs. continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This prespecified secondary analysis of the CRESCENT randomized controlled trial included adults with moderate-to-severe OSA and elevated cardiovascular risk, randomized 1:1 to MAD or CPAP. Outcomes were evaluated according to ASCVD status. The primary outcome was the between-group difference in 24-h ambulatory BP at 6 months. Analyses used ANCOVA models adjusted for baseline BP, with treatment-by-ASCVD interaction testing. Secondary outcomes included excessive daytime sleepiness and circulating cardiovascular biomarkers. Among the 220 participants (median age 61 years, 85.5% male), 145 (66%) had ASCVD. In the ASCVD group, MAD was associated with greater reductions than CPAP in 24-h systolic BP (\u22123.41 mmHg; 95% CI \u22126.56 to \u22120.27; P = 0.028), 24-h mean BP (\u22122.50 mmHg; 95% CI \u22124.90 to \u22120.11; P = 0.040), asleep systolic BP (\u22125.13 mmHg; 95% CI \u22129.36 to \u22120.91; P = 0.018), and asleep mean BP (\u22123.97 mmHg; 95% CI \u22127.31 to \u22120.62; P = 0.021). No significant between-treatment differences were observed in the non-ASCVD group. A significant treatment-by-ASCVD interaction was observed for asleep systolic BP (P = 0.034). Treatment effects on daytime sleepiness and cardiovascular biomarkers were similar across ASCVD subgroups and across treatment groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with OSA and ASCVD, MAD was associated with greater reductions in ambulatory BP than CPAP. Formal evidence of differential treatment effect by ASCVD status was strongest for asleep systolic BP. These findings suggest that patients with OSA and ASCVD may derive greater BP benefit from MAD compared with CPAP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag297","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:20:51Z","timestamp":1780312851000},"source":"Crossref","is-referenced-by-count":0,"title":["Atherosclerotic cardiovascular disease modifies ambulatory blood pressure response to mandibular advancement device vs. CPAP in obstructive sleep apnoea (ASCVD modifies BP response to OSA therapy)"],"prefix":"10.1093","author":[{"given":"Yi-Hui","family":"Ou","sequence":"first","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore ,","place":["Singapore"]},{"name":"Cardiovascular Institute, Beth Israel Deaconess Medical Center , Boston, MA ,","place":["USA"]},{"name":"Department of Medicine, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Tereza","family":"Colpani","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijie","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore ,","place":["Singapore"]},{"name":"Department of Respiratory Medicine, Peking University People\u2019s Hospital , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqiang","family":"Loke","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siew-Pang","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore ,","place":["Singapore"]},{"name":"Cardiovascular Research Institute, National University Heart Centre ,","place":["Singapore"]},{"name":"Department of Cardiology, National University Heart Centre , Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao-Hao","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasya Maria","family":"Kosasih","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay Bahadur","family":"Panday","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National University Heart Centre , Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8520-8860","authenticated-orcid":false,"given":"Tamar","family":"Sofer","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Beth Israel Deaconess Medical Center , Boston, MA ,","place":["USA"]},{"name":"Department of Medicine, Harvard Medical School , Boston, MA ,","place":["USA"]},{"name":"Division of Sleep Medicine, Department of Medicine, Brigham and Women\u2019s Hospital , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4768-5820","authenticated-orcid":false,"given":"Mark Y","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore ,","place":["Singapore"]},{"name":"Cardiovascular Research Institute, National University Heart Centre ,","place":["Singapore"]},{"name":"Department of Cardiology, National University Heart Centre , Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"Cistulli","sequence":"additional","affiliation":[{"name":"Sleep Research Group, Charles Perkins Centre & Northern Clinical School, Faculty of Medicine and Health, University of Sydney , Camperdown, NSW ,","place":["Australia"]},{"name":"Department of Respiratory and Sleep Medicine, Royal North Shore Hospital , St Leonards, NSW 2065 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8777-2705","authenticated-orcid":false,"given":"Chi-Hang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore ,","place":["Singapore"]},{"name":"Cardiovascular Research Institute, National University Heart Centre ,","place":["Singapore"]},{"name":"Department of Cardiology, National University Heart Centre , Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"2026061212382565200_zwag297-B1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s11906-022-01181-w","article-title":"Obstructive sleep apnea and hypertension: updates to a critical relationship","volume":"24","author":"Brown","year":"2022","journal-title":"Curr Hypertens Rep"},{"key":"2026061212382565200_zwag297-B2","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1378\/chest.15-0136","article-title":"Relationship between OSA and hypertension","volume":"148","author":"Torres","year":"2015","journal-title":"Chest"},{"key":"2026061212382565200_zwag297-B3","doi-asserted-by":"crossref","first-page":"335","DOI":"10.5664\/jcsm.7640","article-title":"Treatment of adult obstructive sleep apnea with positive airway pressure: an American academy of sleep medicine clinical practice guideline","volume":"15","author":"Patil","year":"2019","journal-title":"J Clin Sleep Med"},{"key":"2026061212382565200_zwag297-B4","first-page":"773","article-title":"Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015","volume":"11","author":"Ramar","year":"2015","journal-title":"J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med"},{"key":"2026061212382565200_zwag297-B5","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1016\/j.jacc.2024.03.359","article-title":"Mandibular advancement vs CPAP for blood pressure reduction in patients with obstructive sleep apnea","volume":"83","author":"Ou","year":"2024","journal-title":"J Am Coll Cardiol"},{"key":"2026061212382565200_zwag297-B6","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1177\/00220345251361796","article-title":"Mandibular advancement device versus CPAP in severe obstructive sleep apnea","volume":"105","author":"Colpani","year":"2026","journal-title":"J Dent Res"},{"key":"2026061212382565200_zwag297-B7","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1097\/HJH.0000000000003480","article-title":"2023 ESH guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the European society of hypertension endorsed by the European renal association (ERA) and the international society of hypertension (ISH)","volume":"41","author":"Mancia","year":"2023","journal-title":"J Hypertens"},{"key":"2026061212382565200_zwag297-B8","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/03007995.2024.2305248","article-title":"Sympathetic overactivity, hypertension and cardiovascular disease: state of the art","volume":"40","author":"Grassi","year":"2024","journal-title":"Curr Med Res Opin"},{"key":"2026061212382565200_zwag297-B9","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1161\/CIR.0000000000001168","article-title":"2023 AHA\/ACC\/ACCP\/ASPC\/NLA\/PCNA guideline for the management of patients with chronic coronary disease: a report of the American Heart Association\/American College of Cardiology joint committee on clinical practice guidelines","volume":"148","author":"Virani","year":"2023","journal-title":"Circulation"},{"key":"2026061212382565200_zwag297-B10","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/jch.14790","article-title":"Association between nocturnal blood pressure phenotype and adverse cardiovascular prognosis in patients with coronary heart disease and hypertension","volume":"26","author":"Du","year":"2024","journal-title":"J Clin Hypertens"},{"key":"2026061212382565200_zwag297-B11","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1016\/j.jacc.2024.02.059","article-title":"Interactions of obstructive sleep apnea with the pathophysiology of cardiovascular disease, part 1: JACC state-of-the-art review","volume":"84","author":"Javaheri","year":"2024","journal-title":"J Am Coll Cardiol"},{"key":"2026061212382565200_zwag297-B12","doi-asserted-by":"crossref","first-page":"e072853","DOI":"10.1136\/bmjopen-2023-072853","article-title":"Mandibular advancement device versus CPAP in lowering 24-hour blood pressure in patients with obstructive sleep apnoea and hypertension: the CRESCENT trial protocol","volume":"13","author":"Ou","year":"2023","journal-title":"BMJ Open"},{"key":"2026061212382565200_zwag297-B13","first-page":"425","article-title":"AASM criteria for scoring respiratory events: interaction between apnea sensor and hypopnea definition","volume":"35","author":"Thornton","year":"2012","journal-title":"SLEEP"},{"key":"2026061212382565200_zwag297-B14","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1161\/CIRCULATIONAHA.115.019392","article-title":"Obstructive sleep apnea and cardiovascular events after percutaneous coronary intervention","volume":"133","author":"Lee","year":"2016","journal-title":"Circulation"},{"key":"2026061212382565200_zwag297-B15","first-page":"1495","article-title":"Sleep apnoea and cardiovascular outcomes after coronary artery bypass grafting","volume":"106","author":"Koo","year":"2020","journal-title":"Heart Br Card Soc"},{"key":"2026061212382565200_zwag297-B16","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1161\/CIRCULATIONAHA.117.029400","article-title":"INCOSACT initiative (international collaboration of sleep apnea cardiovascular trialists). sleep apnea and cardiovascular disease: lessons from recent trials and need for team science","volume":"136","author":"Drager","year":"2017","journal-title":"Circulation"},{"key":"2026061212382565200_zwag297-B17","doi-asserted-by":"crossref","first-page":"2280","DOI":"10.1001\/jama.2015.16303","article-title":"CPAP vs mandibular advancement devices and blood pressure in patients with obstructive sleep apnea: a systematic review and meta-analysis","volume":"314","author":"Bratton","year":"2015","journal-title":"JAMA"},{"key":"2026061212382565200_zwag297-B18","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S2213-2600(19)30271-1","article-title":"Effect of obstructive sleep apnoea and its treatment with continuous positive airway pressure on the prevalence of cardiovascular events in patients with acute coronary syndrome (ISAACC study): a randomised controlled trial","volume":"8","author":"S\u00e1nchez-de-la-Torre","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2026061212382565200_zwag297-B19","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1056\/NEJMoa1606599","article-title":"CPAP for prevention of cardiovascular events in obstructive sleep apnea","volume":"375","author":"McEvoy","year":"2016","journal-title":"N Engl J Med"},{"key":"2026061212382565200_zwag297-B20","doi-asserted-by":"crossref","first-page":"101229","DOI":"10.1016\/j.smrv.2019.101229","article-title":"Phenotypes of responders to mandibular advancement device therapy in obstructive sleep apnea patients: a systematic review and meta-analysis","volume":"49","author":"Chen","year":"2020","journal-title":"Sleep Med Rev"},{"key":"2026061212382565200_zwag297-B21","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1093\/sleep\/33.8.1075","article-title":"Differences in craniofacial structures and obesity in Caucasian and Chinese patients with obstructive sleep apnea","volume":"33","author":"Lee","year":"2010","journal-title":"Sleep"},{"key":"2026061212382565200_zwag297-B22","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.smrv.2018.01.003","article-title":"The impact of ethnicity on the prevalence and severity of obstructive sleep apnea","volume":"41","author":"Hnin","year":"2018","journal-title":"Sleep Med Rev"},{"key":"2026061212382565200_zwag297-B23","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1002\/clc.23747","article-title":"Obstructive sleep apnea therapy for cardiovascular risk reduction-time for a rethink?","volume":"44","author":"Dissanayake","year":"2021","journal-title":"Clin Cardiol"},{"key":"2026061212382565200_zwag297-B24","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1093\/eurjpc\/zwaf733","article-title":"Bridging the gap between hypertension guidelines and real-life practice: strategies and technological tools for improving long-term population blood pressure control","volume":"33","author":"Bilo","year":"2025","journal-title":"Eur J Prev Cardiol"},{"key":"2026061212382565200_zwag297-B25","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1016\/S0140-6736(02)11911-8","article-title":"Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies","volume":"360","author":"Lewington","year":"2002","journal-title":"Lancet"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwag297\/68518994\/zwag297.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwag297\/68518994\/zwag297.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T16:38:36Z","timestamp":1781282316000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article\/doi\/10.1093\/eurjpc\/zwag297\/8707121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,12]]},"references-count":25,"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwag297","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,12]]},"article-number":"zwag297"}}