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Sleep Apnea and Hypertension

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Abstract

Obstructive sleep apnea is a frequent finding in clinical practice especially with the obesity epidemic and the growing awareness of sleep-disordered breathing as a potential and treatable risk factor for cardiovascular diseases. It frequently coexists undiagnosed activating pathophysiological mechanisms known to participate in development and progression of cardiovascular diseases and resistance to therapeutical strategies. The sympathetic activation and the baroreflex and chemoreflex impairment appear to be the main pathophysiological factors that activating several mechanisms elicit cardiac and vascular damage. Data from cross-sectional population-based studies, prospective studies and meta-analysis have clearly shown the implication of OSA in the development of the hypertensive state and the benefits obtained by continuous positive airway pressure on daytime blood pressure and cardiovascular risk.

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Modified from Ref. [52], with permission

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Modified from Ref. [70], with permission

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References

  1. Fan M, Sun D, Zhou T, Heianza Y, Lv J, Li L, Qi L. Sleep patterns, genetic susceptibility, and incident cardiovascular disease: a prospective study of 385292 UK biobank participants. Eur Heart J. 2020;41:1182–9.

    PubMed  Google Scholar 

  2. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165:1217–39.

    PubMed  Google Scholar 

  3. Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ, Walsleben JA, Finn L, Enright P, Samet JM, Sleep Heart Health Study Research Group. Predictors of sleep-disordered breathing in community-dwelling adults. Arch Intern Med. 2002;162:893–900.

    PubMed  Google Scholar 

  4. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J epidemiol. 2013;177:1006–14.

    PubMed  PubMed Central  Google Scholar 

  5. Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, Hamilton GS, Dharmage SC. Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev. 2017;34:70–81.

    PubMed  Google Scholar 

  6. Young T, Finn L, Austin D, Peterson A. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med. 2003;167:1181–5.

    PubMed  Google Scholar 

  7. Shahar E, Redline S, Young T, Boland LL, Baldwin CM, Nieto FJ, O’Connor GT, Rapoport DM, Robbins JA. Hormone replacement therapy and sleep-disordered breathing. Am J Respir Crit Care Med. 2003;167:1186–92.

    PubMed  Google Scholar 

  8. O’Connor C, Thornley KS, Hanly PJ. Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med. 2000;161:1465–72.

    PubMed  Google Scholar 

  9. Collop NA, Adkins D, Phillips BA. Gender differences in sleep and sleep-disordered breathing. Clin Chest Med. 2004;25:257–68.

    PubMed  Google Scholar 

  10. Redline S, Kump K, Tishler PV, Browner I, Ferrette V. Gender differences in sleep disordered breathing in a community-based sample. Am J Respir Crit Care Med. 1994;149:722–6.

    CAS  PubMed  Google Scholar 

  11. Van Cauter E, Leproult R, Plat L. Age-related changes in slow wave sleep and REM sleep and relationship with growth hormone and cortisol levels in healthy men. JAMA. 2000;284:861–8.

    PubMed  Google Scholar 

  12. Groth M. Sleep apnea in the elderly. Clin Geriatr Med. 2005;21:701–12.

    PubMed  Google Scholar 

  13. Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, Ramar K, Rogers R, Schwab RJ, Weaver EM, Weinstein MD, Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5:263–76.

    PubMed  Google Scholar 

  14. Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999;131:485–91.

    CAS  PubMed  Google Scholar 

  15. Johns MW. Daytime sleepiness, snoring, and obstructive sleep apnea. Chest. 1993;103:30–6.

    CAS  PubMed  Google Scholar 

  16. Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, Khajehdehi A, Shapiro CM. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108:812–21.

    PubMed  Google Scholar 

  17. Logan AG, Bradley TD. Sleep apnea and cardiovascular disease. Curr Hypertens Rep. 2010;12:182–8.

    PubMed  Google Scholar 

  18. Jahaveri S, Barbe F, Campos-Rodriguez F, Dempsey JA, Khayat R, Javaheri S, Malhotra A, Martinez-Garcia MA, Mehra R, Pack AI, Polotsky VY, Redline S, Somers VK. Sleep apnea: types, mechanisms, and clinical cardiovascular consequences. J Am Coll Cardiol. 2017;69:841–58.

    Google Scholar 

  19. Dudley KA, Patel SR. Disparities and genetic risk factors in obstructive sleep apnea. Sleep Med. 2016;18:96–102.

    PubMed  Google Scholar 

  20. Tantgurson V, Krogstad O, Espeland L, Lyberg T. Obstructive sleep apnea: multiple comparisons of cephalometric variables of obese and non-obese patients. J Craniomaxillofac Surg. 2000;28:204–12.

    Google Scholar 

  21. Chi L, Comyn FL, Keenan BT, Cater J, Maislin G, Pack AL, Schwab RJ. Heritability of craniofacial structures in normal subjects and patients with sleep apnea. Sleep. 2014;37:1689–98.

    PubMed  PubMed Central  Google Scholar 

  22. Dempsey JA, Veasey SC, Morgan BJ, O’Donnell CP. Pathophysiology od sleep apnea. Physiol Rev. 2010;90:47–112.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Eckert DJ, White DP, Jordan AS, Malhotra A, Weellman A. Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets. Am J Respir Crit Care Med. 2013;188:996–1004.

    PubMed  PubMed Central  Google Scholar 

  24. Edwards BA, Wellman A, Sands SA, Owens RL, Eckert DJ, White DP, Malhotra A. Obstructive sleep apnea in older adults is a distinctly different physiological phenotype. Sleep. 2014;37:1227–36.

    PubMed  PubMed Central  Google Scholar 

  25. Joosten SA, Edwards BA, Wellman A, Turton A, Skuza EM, Berger PJ, Hamilton GS. The effect of body position on physiological factors that contribute to obstructive sleep apnea. Sleep. 2015;38:1469–78.

    PubMed  PubMed Central  Google Scholar 

  26. Thomas RJ, Mietus JE, Peng CK, Goldberger AL. An electrocardiogram based technique to assess cardiopulmonary coupling during sleep. Sleep. 2005;28:1151–61.

    PubMed  Google Scholar 

  27. Jacquin TD. Reorganization of pontine rhytmogenic neuronal networks in Krox-20 knockout mice. Neuron. 1996;17:747–58.

    CAS  PubMed  Google Scholar 

  28. Lohnes D, Mark M, Mendelsohn C, Dolle P, Dierich A, Gorry P, Gansmuller A, Chambon P. Function of the retinoic acid receptors (RARs) during development. Craniofacial and skeletal abnormalities in RAR double mutans. Development. 1994;120:2723–48.

    CAS  PubMed  Google Scholar 

  29. Kurihara Y, Kurihara H, Suzuki H, Kodama T, Maemura K, Nagai R, Oda H, Kuwaki T, Cao WH, Kamada N, Jishage K, Ouchi Y, Azuma S, Toyoda Y, Ishikawa T, Kumada M, Yazaki Y. Elevated blood pressure and craniofacial abnormalities in mice deficient in endothelin-1. Nature. 1994;368:703–10.

    CAS  PubMed  Google Scholar 

  30. Erickson JT, Conover JC, Borday V, Champagnat J, Barbacid M, Yancopoulos G, Katz DM. Mice lacking brain-derived neurotrophic factor exhibit visceral sensory neuron losses distinct from mice lacking NT4 and display a severe developmental deficit in control of breathing. J Neurosci. 1996;16:5361–71.

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Sanford LP, Ormsby I, Gittenberger-de Groot AC, Hannu S, Friedman R, Boivin GP, Cardell EL, Doetschman T. TGF Beta-2 knockout mice have multiple developmental defects that are non-overlapping with other TGF Beta knockout phenotypes. Development. 1997;124:2659–70.

    CAS  PubMed  Google Scholar 

  32. Thannickal TC, Moore RY, Nienhuis R, Ramanathan L, Gulyani S, Aldrich M, Conford M, Siegel JM. Reduced number of hypocretin neurons in human narcolepsy. Neuron. 2000;27:469–74.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Saarelainen S, Seppala E, Laasonen K, Hasan J. Cirulating endothelin-1 in obstructive sleep apnea. Endothelium. 1997;5:115–8.

    CAS  PubMed  Google Scholar 

  34. Vgontzas AN, Papanicolaou DA, Bixler EO, Kales A, Tyson K, Chrousos GP. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab. 1997;82:1313–6.

    CAS  PubMed  Google Scholar 

  35. Comuzzie A, Hixson J, Almasy L, Mitchell BD, Mahaney MC, Dyer TD, Stern MP, MacCluer JW, Blangero J. A major quantitative trait locus determining serum leptin levels and fat mass is located in chromosome 2. Nat Genet. 1997;15:273–6.

    CAS  PubMed  Google Scholar 

  36. Sina M, Hinney A, Ziegler A, Neupert T, Mayer H, Siegfried W, Blum WF, Remschmidt H, Hebebrand J. Phenotypes in three pedigrees with autosomal dominant obesity caused by haploinsufficiency mutations in melanocortin-4 receptor gene. Am J Hum Genet. 1999;65:1501–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. O’Donnell CP, Schaub CD, Haines AS, Berkowitz DE, Tankersley CG, Schwartz AR, Smith PL. leptin prevents respiratory depression in obesity. Am J Respir Crit Care Med. 1999;159:1477–84.

    PubMed  Google Scholar 

  38. Palmer LJ, Buxbaum SG, Larkin EK, Patel SR, Elston RC, Tishler PV, Redline S. Whole genome scan for obstructive sleep apnea and obesity in African–American families. Am J Respir Crit care Med. 2004;169:1314–21.

    PubMed  Google Scholar 

  39. Grassi G, Padmanabhan S, Menni C, Seravalle G, Lee WK, Bombelli M, Brambilla G, Quarti-Trevano F, Giannattasio C, Cesana G, Dominiczak A, Mancia G. Association between ADRA1A gene and the metabolic syndrome: candidate genes and functional counterpart in the PAMELA population. J Hypertens. 2011;29:1121–7.

    CAS  PubMed  Google Scholar 

  40. Bayliss DA, Viana F, Talley EM, Berger AJ. Neuromodulation of hypoglossal motoneurons: cellular and developmental mechanisms. Respir Physiol. 1997;110:139–50.

    CAS  PubMed  Google Scholar 

  41. Jelev A, Sood S, Liu H, Nolan P, Horner RL. Microdialysis perfusion of 5-HT into hypoglossal motor nucleus differentially modulates genioglossus activity across natural sleep-awake state in rats. J Physiol. 2001;532:467–81.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Van Lunteren E. Muscles of the pharynx: structural and contractile properties. Ear Nose Troat J. 1993;72:27–9.

    Google Scholar 

  43. Yilmaz M, Bayazit AY, Ciftci TU, Erdal ME, Urhan M, Kokturk O, Kemaloglu YK, Inal E. Association of serotonin transporter gene polymorphism with obstructive sleep apnea syndrome. Laryngoscope. 2005;115:832–6.

    Google Scholar 

  44. Lin JS, Anaclet C, Sergeeva OA, Haas HL. The waking brain: an update. Cell Mol Life Sci. 2011;68:2499–512.

    CAS  PubMed  PubMed Central  Google Scholar 

  45. Pedrazzoli M, Mazzotti DR, Ribeiro AO, Mendes JV, Bittencourt LRA, Tufik S. A single nucleotide polymorphism in the HOMER1 gene is associated with sleep latency and theta power in sleep electroencephalogram. PlosOne. 2020;15:e0223632.

    CAS  Google Scholar 

  46. American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep. 1999;22:667–89.

    Google Scholar 

  47. Sateia MJ. International classification of sleep disorders—3rd ed: highlights and modifications. Chest. 2014;146:1387–94.

    PubMed  Google Scholar 

  48. Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Investig. 1995;96:1897–904.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Heistad DD, Abboud FM, Mark AL, Schmid PG. Effect of baroreceptor activity on ventilatory response to chemoreceptor stimulation. J Appl Physiol. 1975;39:411–6.

    CAS  PubMed  Google Scholar 

  50. Somers VK, Mark AL, Abboud FM. Potentiation of sympathetic responses to hypoxia in borderline hypertensive subjects. Hypertension. 1988;11(6 Pt 2):608–12.

    CAS  PubMed  Google Scholar 

  51. Carlson JT, Hedner J, Elam M, Ejnell H, Sellgren J, Wallin BG. Augmented resting sympathetic activity in awake patients with obstructive sleep apnea. Chest. 1993;103:1763–8.

    CAS  PubMed  Google Scholar 

  52. Grassi G, Seravalle G, Brambilla G, Buzzi S, Volpe M, Cesana F, Dell’oro R, Mancia G. Regional differences in sympathetic activation in lean and obese normotensive individuals with obstructive sleep apnoea. J Hypertens. 2014;32:383–8.

    CAS  PubMed  Google Scholar 

  53. Narkiewicz K, Montano N, Cogliati C, van de Borne PJ, Dyken ME, Somers VK. Altered cardiovascular variability in obstructive sleep apnea. Circulation. 1998;98:1071–7.

    CAS  PubMed  Google Scholar 

  54. Singh JP, Larson MC, Tsuji H, Evans JC, O’Donnell CJ, Levy D. Reduced heart rate variability and new-onset hypertension: insights into pathogenesis of hypertension: the Framingham Heart Study. Hypertension. 1998;32:293–7.

    CAS  PubMed  Google Scholar 

  55. Mancia G. Prognostic value of long-term blood pressure variability: the evidence is growing. Hypertension. 2011;57:141–3.

    CAS  PubMed  Google Scholar 

  56. Janssen C, Pathak A, Grassi G, van de Borne P. Endothelin contributes to the blood pressure rise triggered by hypoxia in severe obstructive sleep apnea. J Hypertens. 2017;35:118–24.

    CAS  PubMed  Google Scholar 

  57. Prabhakar NR. Sleep apneas: an oxidative stress? Am J Respir Crit Care Med. 2002;165:859–60.

    PubMed  Google Scholar 

  58. Shamsuzzaman AS, Winnicki M, Lanfranchi P, Wolk R, Kara T, Accurso V, Somers VK. Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation. 2002;105:2462–4.

    CAS  PubMed  Google Scholar 

  59. Ohga E, Nagase T, Tomita T, Teramoto S, Matsuse T, Katayama H, Ouchi Y. Increased levels of circulating ICAM-1, VCAM-1, and L-selectin in obstructive sleep apnea syndrome. J Appl Physiol. 1999;87:10–4.

    CAS  PubMed  Google Scholar 

  60. Schulz R, Mahmoudi S, Hattar K, Sibelius U, Olschewski H, Mayer K, Seeger W, Grimminger F. Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea: impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med. 2000;162:566–70.

    CAS  PubMed  Google Scholar 

  61. Chin K, Nakamura T, Shimizu K, Mishima M, Nakamura T, Miyasaka M, Ohi M. Effects of nasal continuous positive airway pressure on soluble cell adhesion molecules in patients with obstructive sleep apnea syndrome. Am J Med. 2000;109:562–7.

    CAS  PubMed  Google Scholar 

  62. Sanner BM, Konermann M, Tepel M, Groetz J, Mummenhoff C, Zidek W. Platelet function in patients with obstructive sleep apnea syndrome. Eur Respir J. 2000;16:648–52.

    CAS  PubMed  Google Scholar 

  63. Von KR, Loredo JS, Ancoli-Israel S, Mills PJ, Natarajan L, Dimsdale JE. Association between polysomnographic measures of disrupted sleep and prothrombotic factors. Chest. 2007;131:733–9.

    Google Scholar 

  64. Spiegel K, Leproult R, van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354:1435–9.

    CAS  PubMed  Google Scholar 

  65. Phillips BG, Kato M, Narkiewicz K, Choe I, Somers VK. Increases in leptin levels, sympathetic drive, and weight gain in obstructive sleep apnea. Am J Physiol Heart Circ Physiol. 2000;279:H234–7.

    CAS  PubMed  Google Scholar 

  66. Duran J, Esnaola S, Rubio R, Iztueta A. Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30–70 yr. Am j Respir Crit Care. 2001;163:685–9.

    CAS  Google Scholar 

  67. Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, D’Agostino RB, Newman AB, Lebowitz MD, Pickering TG. Association of sleep-disorder breathing, sleep apnea, and hypertension in a large community-based study. JAMA. 2000;283:1829–36.

    CAS  PubMed  Google Scholar 

  68. Bixler EO, Vgontas AN, Lin HM, Ten Have T, Leiby BE, Vela-Bueno A, Kales A. Association of hypertension and sleep-disordered breathing. Arch Intern Med. 2000;160:2289–95.

    CAS  PubMed  Google Scholar 

  69. Young T, Peppard P, Palta M, Mae Hla K, Finn L, Morgan B, Skatrud J. Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med. 1997;157:1746–52.

    CAS  PubMed  Google Scholar 

  70. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disorder breathing and hypertension. N Engl J Med. 2000;342:1378–84.

    CAS  PubMed  Google Scholar 

  71. Hu FB, Willett WC, Colditz GA, Ascherio A, Speizer FE, Rosner B, Hennekens CH, Stampfer MJ. Prospective study of snoring and risk of hypertension in women. Am J Epidemiol. 1999;150:806–16.

    CAS  PubMed  Google Scholar 

  72. Grote L, Hedner J, Peter JH. Mean blood pressure, pulse pressure and grade of hypertension in untreated hypertensive patients with sleep-related breathing disorder. J Hypertens. 2001;19:683–90.

    CAS  PubMed  Google Scholar 

  73. Lavie P, Herer P, Hoffstein V. Obstructive sleep apnea syndrome as a risk factor for hypertension: a population study. Br Med J. 2000;320:479–82.

    CAS  Google Scholar 

  74. Davies CW, Crosby JH, Mullins RL, Barbour C, Davies RJ, Stradling JR. Case-control study of 24 hour ambulatory blood pressure in patients with obstructive sleep apnea and normal matched control subjects. Thorax. 2000;55:736–40.

    CAS  PubMed  PubMed Central  Google Scholar 

  75. Hou H, Zhao Y, Yu W, Dong H, Xue X, Ding J, Xing W, Wang W. Association of obstructive sleep apnea with hypertension: a systematic review and meta-analysis. J Glob Health. 2018. https://doi.org/10.7189/jogh.08.010405.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Brooks D, Horner RL, Kozar LF, Render-Teixeira CL, Phillipson EA. Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J Clin Investig. 1997;99:106–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  77. Parker JD, Brooks D, Kozar LF, Render-Teixeira CL, Horner RL, Dougla BT, Phillipson EA. Acute and chronic effects of airway obstruction on canine left ventricular performance. Am J Respir Crit Care Med. 1999;160:1888–96.

    CAS  PubMed  Google Scholar 

  78. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement D, Coca A, De Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen S, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder R, Shlyakhto E, Tsioufis K, Aboyans V, Desormais I. 2018 Practice Guidelines for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Blood Press. 2018;27:314–40.

    PubMed  Google Scholar 

  79. Faccenda JF, Mackay TW, Boon NA, Douglas NJ. Randomized placebo-controlled trial of continuous positive airway pressure on blood pressure in the sleep apnea-hypopnea syndrome. Am J Respir Crit Care Med. 2001;163:344–8.

    CAS  PubMed  Google Scholar 

  80. Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, Peter JH. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation. 2003;107:68–73.

    PubMed  Google Scholar 

  81. Dhillon S, Chung SA, Fargher T, Hutere N, Shapiro CM. Sleep apnea, hypertension, and the effects of continuous positive airway pressure. Am J Hypertens. 2005;18:594–600.

    PubMed  Google Scholar 

  82. Garcia MAM, Capote F, Campos-Rodriguez F, Lloberes P, Spanish Sleep Network. Effects of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension. The HIPARCO Randomized Clinical Trial. The HIPARCO Randomized Clinical Trial. JAMA. 2013;310:2407–15.

    Google Scholar 

  83. Montesi SB, Edwards BA, Malhotra A, Bakker J. The effect of continuous positive pressure treatment on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med. 2021;8:587–96.

    Google Scholar 

  84. Seravalle G, Grassi G. Sympathetic nervous system, hypertension, obesity and metabolic syndrome. High Blood Press Cardiovasc Prev. 2016;23:175–9.

    CAS  PubMed  Google Scholar 

  85. Grassi G, Seravalle G, Brambilla G, Pini C, Alimento M, Facchetti R, Spaziani D, Cuspidi C, Mancia G. Marked sympathetic activation and baroreflex dysfunction in true resistant hypertension. Int J Cardiol. 2014;177(3):1020–5.

    PubMed  Google Scholar 

  86. Cuspidi C, Tadic M, Gherbesi E, Sala C, Grassi G. Targeting subclinical organ damage in obstructive sleep apnea: a narrative review. J Hum Hypertens. 2021;35:26–36.

    PubMed  Google Scholar 

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  1. Cardiology Department, IRCCS Istituto Auxologico Italiano, S. Luca Hospital, Piazza Brescia 20, 20149, Milan, Italy

    Gino Seravalle

  2. Clinica Medica, S. Gerardo dei Tintori Hospital, University Milano-Bicocca, Monza, Italy

    Guido Grassi

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Seravalle, G., Grassi, G. Sleep Apnea and Hypertension. High Blood Press Cardiovasc Prev 29, 23–31 (2022). https://doi.org/10.1007/s40292-021-00484-4

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