Abstract
Obstructive sleep apnea (OSA) and hypertension (HT) are widespread, sometimes associated disorders that enhance each other and result in high morbidity and mortality rates. Resistant hypertension (RHT) is a specific condition defined as high blood pressure that remains uncontrolled despite treatment with at least three antihypertensive drugs (including a diuretic) at optimal doses. Given that RHT is very common in OSA patients, OSA is now considered one of the leading causes of RHT and RHT screening is mandatory in such cases. Some of the mechanisms seen in HT pathogenesis are also present (with specific particularities) in the OSA-HT association. Thus, factors like increased sympathetic tone, renin-angiotensinaldosterone system, endothelial dysfunction, vasoactive substances, inflammation, oxidative stress, nocturnal rostral fluid shift and excessive daytime sleepiness add their burden to the pathological chain, leading to both resistance and nondipping profile of HT. Consequently, we can assume that continuous positive airway pressure (CPAP) therapy in OSA patients has an impact on HT and HT resistance. This review describes the effect of CPAP on the above-mentioned links of the pathological chain, while providing information on new methods of assessing the cardiovascular risk in these patients, a history of the most important studies on the OSA-RHT association and the outcomes of a recent meta-analysis showing a positive effect of CPAP on 24-hour BP monitoring in patients with OSA and RHT compared to standard antihypertensive treatment.
Keywords: Arterial hypertension, blood pressure variability, continuous positive airway pressure, meta-analysis, obstructive sleep apnea syndrome, resistant hypertension.
Current Respiratory Medicine Reviews
Title:Relation Between Obstructive Sleep Apnea Syndrome and Resistant Hypertension - The Tip of the Iceberg
Volume: 11 Issue: 4
Author(s): Oana Claudia Deleanu, Ana-Maria Nebunoiu, Miruna Mihaela Micheu, Andra Elena Malaut and Florin Dumitru Mihaltan
Affiliation:
Keywords: Arterial hypertension, blood pressure variability, continuous positive airway pressure, meta-analysis, obstructive sleep apnea syndrome, resistant hypertension.
Abstract: Obstructive sleep apnea (OSA) and hypertension (HT) are widespread, sometimes associated disorders that enhance each other and result in high morbidity and mortality rates. Resistant hypertension (RHT) is a specific condition defined as high blood pressure that remains uncontrolled despite treatment with at least three antihypertensive drugs (including a diuretic) at optimal doses. Given that RHT is very common in OSA patients, OSA is now considered one of the leading causes of RHT and RHT screening is mandatory in such cases. Some of the mechanisms seen in HT pathogenesis are also present (with specific particularities) in the OSA-HT association. Thus, factors like increased sympathetic tone, renin-angiotensinaldosterone system, endothelial dysfunction, vasoactive substances, inflammation, oxidative stress, nocturnal rostral fluid shift and excessive daytime sleepiness add their burden to the pathological chain, leading to both resistance and nondipping profile of HT. Consequently, we can assume that continuous positive airway pressure (CPAP) therapy in OSA patients has an impact on HT and HT resistance. This review describes the effect of CPAP on the above-mentioned links of the pathological chain, while providing information on new methods of assessing the cardiovascular risk in these patients, a history of the most important studies on the OSA-RHT association and the outcomes of a recent meta-analysis showing a positive effect of CPAP on 24-hour BP monitoring in patients with OSA and RHT compared to standard antihypertensive treatment.
Export Options
About this article
Cite this article as:
Deleanu Claudia Oana, Nebunoiu Ana-Maria, Micheu Mihaela Miruna, Malaut Elena Andra and Mihaltan Dumitru Florin, Relation Between Obstructive Sleep Apnea Syndrome and Resistant Hypertension - The Tip of the Iceberg, Current Respiratory Medicine Reviews 2015; 11 (4) . https://dx.doi.org/10.2174/1573398X11666150914212528
DOI https://dx.doi.org/10.2174/1573398X11666150914212528 |
Print ISSN 1573-398X |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6387 |
Call for Papers in Thematic Issues
Chronic obstructive pulmonary disease (COPD) from childhood to adulthood: from the past to the future
Chronic obstructive pulmonary disease (COPD) is one of the three leading causes of death worldwide, with a major prevalence in low- and middle-income countries, resulting in a high social and economic cost. It is a heterogeneous respiratory disease, treatable and preventable, that causes persistent and often progressive airway obstruction in ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Reduction of Sodium Intake is a Prerequisite for Preventing and Curing High Blood Pressure in Hypertensive Patients - Second Part: Guidelines
Current Hypertension Reviews Migraine: Pathophysiology, Pharmacology, Treatment and Future Trends
Current Vascular Pharmacology Weight Loss Following Roux-en-Y Gastric Bypass Surgery: A Systematic Review of Psychosocial Predictors
Current Psychiatry Reviews A Quantitative LC-MS/MS Method for the Simultaneous Determination of the Presence of R-α-lipoic Acid and S-α-lipoic Acid After Protein Precipitation in Rat Plasma and its Application in a Toxicokinetic Study
Current Pharmaceutical Analysis Interstitial Lung Disease Associated with Collagen Vascular Disease
Clinical Anti-Inflammatory & Anti-Allergy Drugs (Discontinued) Expression Activity of Selected Proangiogenic Factors in Patients with Limb Ischemia
Current Metabolomics Effects of Acarbose on Proinsulin and Insulin Secretion and their Potential Significance for the Intermediary Metabolism and Cardiovascular System
Current Diabetes Reviews Current Perspectives on Hypertension in Asian Indians
Current Hypertension Reviews Does Post-/Long-COVID-19 Affect Renal Stiffness without Causing any Chronic Systemic Disorders?
Current Medical Imaging Effects of Biologic Agents and Other Disease-Modifying Antirheumatic Drugs on Cardiovascular Outcomes in Psoriasis and Psoriatic Arthritis: A Systematic Review
Current Pharmaceutical Design Subject Index To Volume 4
Cardiovascular & Hematological Agents in Medicinal Chemistry Non-Analgesic Effects of Opioids: Opioid-induced Nausea and Vomiting: Mechanisms and Strategies for their Limitation
Current Pharmaceutical Design Nutritional Interventions and Considerations for the Development of Low Calorie or Sugar Free Foods
Current Diabetes Reviews Diabetic Neuropathy: Update on Pathophysiological Mechanism and the Possible Involvement of Glutamate Pathways
Current Diabetes Reviews The Estrogenic Burden on Vascular Risk in Male-to-Female Transsexuals
Current Pharmaceutical Design Exosomes and Exosomal microRNAs in Age-associated Stroke
Current Vascular Pharmacology Approaches for the Development of Drugs for Treatment of Obesity and Metabolic Syndrome
Current Pharmaceutical Design Unique Coronary Artery Disease Differences in Women as Related to Revascularization
Current Medicinal Chemistry Nanomaterial Based Approaches for the Diagnosis and Therapy of Cardiovascular Diseases
Current Pharmaceutical Design Therapeutic Effects of Renal Denervation on Renal Failure
Current Neurovascular Research