Resistant hypertension and obstructive sleep apnea

Akram Khan, Nimesh K. Patel, Daniel J. O'Hearn, Supriya Khan

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Hypertension (HTN) is a modifiable, highly prevalent risk factor for cardiovascular morbidity and renal dysfunction worldwide. In the United States, HTN affects one in three adults, contributes to one out of every seven deaths and to nearly half of all cardiovascular disease-related deaths. HTN is considered resistant when the blood pressure remains above goal despite lifestyle modification and administration of three antihypertensive agents of different classes including a diuretic. Large population-based studies have suggested that obstructive sleep apnea (OSA) is a risk factor for resistant HTN. The mechanism proposed is a pattern of intermittent hypoxia associated with hyperaldosteronism, increased sympathetic tone, endothelial dysfunction, and inflammation. In this review we discuss the association between OSA and resistant HTN, the physiologic mechanisms linking OSA with resistant HTN, and the effect of continuous positive airway pressure therapy (CPAP) on blood pressure in patients with resistant HTN. While the reduction in blood pressure with CPAP is usually modest in patients with OSA, a decrease of only a few mmHg in blood pressure can significantly reduce cardiovascular risk. Patients presenting to a center specializing in management of hypertension should be screened and treated for OSA as a potentially modifiable risk factor.

Original languageEnglish (US)
Article number193010
JournalInternational Journal of Hypertension
Volume2013
DOIs
StatePublished - 2013

Fingerprint

Obstructive Sleep Apnea
Hypertension
Blood Pressure
Continuous Positive Airway Pressure
Hyperaldosteronism
Diuretics
Antihypertensive Agents
Life Style
Cardiovascular Diseases
Inflammation
Morbidity
Kidney
Therapeutics
Population

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Resistant hypertension and obstructive sleep apnea. / Khan, Akram; Patel, Nimesh K.; O'Hearn, Daniel J.; Khan, Supriya.

In: International Journal of Hypertension, Vol. 2013, 193010, 2013.

Research output: Contribution to journalArticle

Khan, Akram ; Patel, Nimesh K. ; O'Hearn, Daniel J. ; Khan, Supriya. / Resistant hypertension and obstructive sleep apnea. In: International Journal of Hypertension. 2013 ; Vol. 2013.
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