Resistant Hypertension and Sleep Apnea: Pathophysiologic Insights and Strategic Management
Resistant hypertension is common among adults with hypertension affecting up to 30% of patients. The treatment of resistant hypertension is important because suboptimal blood pressure control is the leading preventable cause of death worldwide. A frequent comorbid condition in patients with resistant hypertension is obstructive sleep apnea. The pathophysiology of sleep apnea–associated hypertension is characterized by sustained adrenergic activation and volume retention often posing treatment challenges in patients with resistant hypertension. This review will address some of the epidemiologic data associating apnea with the pathogenesis of resistant hypertension. Diagnosis and management of apnea and its associated hypertension will also be considered.
KeywordsSleep-disordered breathingSleep apneaDrug-resistant hypertensionObesityDiureticsContinuous positive airway pressure
Clinical Trial Acronyms
Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial
Blood Pressure Lowering Arm of the Anglo-Scandinavian Cardiac Outcomes Trial
Sleep Heart Health Study
Wisconsin Sleep Cohort Study