RESUMO Objetivo: Avaliar sistematicamente os efeitos da continuous positive airway pressure (CPAP, pressão positiva contínua nas vias aéreas) na pressão arterial em pacientes com hipertensão resistente e apneia obstrutiva do sono (AOS). Métodos: Estudos que investigassem os efeitos da CPAP na pressão arterial em pacientes com hipertensão resistente e AOS foram buscados nos seguintes bancos de dados eletrônicos: Cochrane Library; PubMed; ScienceDirect e Web of Science. Os estudos selecionados foram submetidos a avaliação de qualidade, meta-análise e teste de heterogeneidade. Resultados: Foram incluídos na meta-análise seis ensaios clínicos controlados aleatórios. As estimativas combinadas das alterações das médias de pressão arterial sistólica e pressão arterial diastólica (medidas por meio de monitoração ambulatorial da pressão arterial durante 24 h) foram de −5,40 mmHg (IC95%: −9,17 a −1,64; p = 0,001; I2 = 74%) e −3,86 mmHg (IC95%: −6,41 a −1,30; p = 0,00001; I2 = 79%), respectivamente. Conclusões: O tratamento com CPAP é capaz de reduzir significativamente a pressão arterial em pacientes com hipertensão resistente e AOS.

ABSTRACT Objective: To evaluate systematically the effects of continuous positive airway pressure (CPAP) on blood pressure in patients with resistant hypertension and obstructive sleep apnea (OSA). Methods: The Cochrane Library, PubMed, ScienceDirect, and the Web of Science were searched for studies investigating the effects of CPAP on blood pressure in patients with resistant hypertension and OSA. The selected studies underwent quality assessment and meta-analysis, as well as being tested for heterogeneity. Results: Six randomized controlled trials were included in the meta-analysis. The pooled estimates of the changes in mean systolic blood pressure and mean diastolic blood pressure (as assessed by 24-h ambulatory blood pressure monitoring) were −5.40 mmHg (95% CI: −9.17 to −1.64; p = 0.001; I2 = 74%) and −3.86 mmHg (95% CI: −6.41 to −1.30; p = 0.00001; I2 = 79%), respectively. Conclusions: CPAP therapy can significantly reduce blood pressure in patients with resistant hypertension and OSA.

Lignin is a major cell wall component of vascular plants that provides mechanical strength and hydrophobicity to vascular vessels. However, the presence of lignin limits the effective use of crop straw in many agroindustrial processes. Here, we generated transgenic maize plants in which the expression of a lignin biosynthetic gene encoding CCoAOMT , a key enzyme involved in the lignin biosynthesis pathway was downregulated by RNA interference (RNAi). RNAi of CCoAOMT led to significantly downregulated expression of this gene in transgenic maize compared with WT plants. These transgenic plants exhibited a 22.4% decrease in Klason lignin content and a 23.3% increase in cellulose content compared with WT plants, which may reflect compensatory regulation of lignin and cellulose deposition. We also measured the lignin monomer composition of the RNAi plants by GC-MS and determined that transgenic plants had a 57.08% higher S/G ratio than WT plants. In addition, histological staining of lignin with Wiesner reagent produced slightly more coloration in the xylem and sclerenchyma than WT plants. These results provide a foundation for breeding maize with low-lignin content and reveal novel insights about lignin regulation via genetic manipulation of CCoAOMT expression.