Hypertension and obstructive sleep apnea

Cai, Anping; Wang, Ling; Zhou, Yingling

doi:10.1038/hr.2016.11

Cited by 87 publications

(56 citation statements)

References 65 publications

(85 reference statements)

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“…However, if they used AHI ≥ 5 to define OSA, it was probable that OSA prevalence in resistant hypertensive patients would be even higher. Nevertheless, these findings together supported the notion that OSA might be the most significant cause of resistant hypertension and patients with difficult BP control despite treating with 3 or more BP lowering drugs should routinely undergo OSA evaluation18.…”

Section: Discussionmentioning

confidence: 57%

Association of aldosterone excess and apnea-hypopnea index in patients with resistant hypertension

Guo

et al. 2017

Sci Rep

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The present study was to investigate the association of aldosterone excess and apnea-hypopnea index (AHI) in patients with resistant hypertension. Patients with resistant hypertension were enrolled and baseline characteristics including plasma aldosterone concentration (PAC) and 24 h-urine aldosterone levels were collected and compared between groups with different degrees of AHI as assessed by polysomnography. Association of key variables and AHI was then evaluated by univariate and multiple linear regression analysis. A total of 534 patients with resistant hypertension were enrolled and mean age was 57 ± 11 years. Overall, mean number of AHI was 21.7 ± 9.6 and nearly 92.3% of resistant hypertensive patients had obstructive sleep apnea (OSA). Mean PAC and 24 h-urine aldosterone level was 12.4 ± 6.3 ng/dL and 13.1 ± 6.8 ug, respectively. Compared with other groups, participants in the severe OSA group (AHI ≥ 30) had significantly higher PAC and 24 h-urine aldosterone level. Multiple linear regression analysis showed that PAC and 24 h-urine aldosterone levels were positively associated with AHI, while spironolactone was negatively associated with AHI, independent of age, gender, body mass index, smoking, plasma renin activity and diuretics. OSA is highly prevalent in patients with resistant hypertension and both PAC and 24 h-urine aldosterone level are significantly associated with AHI.

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Section: Discussionmentioning

confidence: 57%

Association of aldosterone excess and apnea-hypopnea index in patients with resistant hypertension

Guo

et al. 2017

Sci Rep

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“…Higher values and blunted circadian variations (lack of physiological decrease during nighttime) of BP are known phenomena associated with significant SA in normal and hypertensive subjects. The best example in this regard is resistant hypertension associated with severe forms of (mainly obstructive) SA in the majority of cases, with a decreased diurnal index as a rule [15]. …”

Section: Discussionmentioning

confidence: 99%

The Influence of Sleep Apnea on 24-Hour and Nocturnal ECG and Blood Pressure Parameters in Patients with Acute Heart Failure

et al. 2018

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Objective: To investigate the influence of sleep apnea (SA) on ECG and blood pressure (BP) monitoring parameters in patients with acute heart failure (AHF). Methods: A total of 51 hospitalized patients with AHF (13 women, 38 men, mean age 60.8 years) underwent 24-hour combined monitoring of ECG and BP and SA testing before discharge. Heart rhythm (mean heart rate, arrhythmias, pauses, QT interval, heart rate variability) and BP (mean systolic and diastolic values, variability, circadian variation) parameters were obtained for the whole day and for nighttime (22: 00–06: 00). Depending on SA severity, the patients were divided into two groups (respiratory event index, REI, < 15/h and ≥15/h). Comparisons of parameters between the two groups were performed using t test and χ² test (alpha < 0.05 for significance). Results: A total of 29 (56.9%) patients had REI ≥15/h. In this group, the systolic and diastolic BP values (24-hour and nighttime) were significantly higher (p < 0.05). BP variability did not differ, and a markedly blunted circadian variation of both the systolic and diastolic values was observed. In the group with REI ≥15/h, we found a higher nocturnal versus diurnal mean heart rate ratio (p = 0.046) and a greater occurrence of nocturnal versus diurnal ventricular premature beats (p = 0.0098). Conclusion: The presence of significant SA was found to influence the BP values and nocturnal ventricular ectopy in patients with stabilized AHF. SA, 24-hour ECG, and BP monitoring could provide important information with potential impact on patient management.

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“…The control of modifiable factors which contribute to both conditions-reducing obesity, smoking, and alcohol consumption-is considered a very effective, first step treatment modality of comorbid OSA and hypertension [23,24,36].…”

Section: The Effect Of Osa Interventions On Comorbid Hypertensionmentioning

confidence: 99%

“…Regarding the effect of antihypertensive drugs on OSA in hypertensive patients, the (sometimes conflicting) data do not support clearly a specific beneficial effect of the usually prescribed drugs (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium-channel blockers, diuretics, beta-blockers) [23,24]. However, hypertensive patients with hyperaldosteronism and those with resistant hypertension could benefit from spironolactone as first choice therapy, with proven beneficial effects on OSA.…”

Section: Strongmentioning

confidence: 99%

Hypertension and Sleep Apnea

Frigy¹,

Kocsis²

2018

Blood Pressure - From Bench to Bed

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Diagnosis and treatment of comorbid conditions in hypertension are essential for efficient blood pressure control and for decreasing adverse clinical events and mortality. Sleep apnea, mainly its obstructive form, has a high prevalence both in the general population and in hypertensive patients, the main reason being the worldwide epidemic of obesity. This chapter summarizes the principal issues related to hypertension-sleep apnea relationship: definition of terms, epidemiological data and evidences, clinical manifestations of sleep apnea, pathophysiological background of the adverse effects of sleep apnea on the cardiovascular system, screening and definitive diagnosis, and the effects of specific and nonspecific sleep apnea interventions on hypertension.

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Hypertension and obstructive sleep apnea

Cited by 87 publications

References 65 publications

Association of aldosterone excess and apnea-hypopnea index in patients with resistant hypertension

Association of aldosterone excess and apnea-hypopnea index in patients with resistant hypertension

The Influence of Sleep Apnea on 24-Hour and Nocturnal ECG and Blood Pressure Parameters in Patients with Acute Heart Failure

Hypertension and Sleep Apnea

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