Current Diabetes Reports

, Volume 11, Issue 1, pp 64–69

Resistant Hypertension and Sleep Apnea: Pathophysiologic Insights and Strategic Management

  • Stephen K. Williams
  • Joseph Ravenell
  • Girardin Jean-Louis
  • Ferdinand Zizi
  • James A. Underberg
  • Samy I. McFarlane
  • Gbenga Ogedegbe
Article

DOI: 10.1007/s11892-010-0161-z

Cite this article as:
Williams, S.K., Ravenell, J., Jean-Louis, G. et al. Curr Diab Rep (2011) 11: 64. doi:10.1007/s11892-010-0161-z

Abstract

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.

Keywords

Sleep-disordered breathingSleep apneaDrug-resistant hypertensionObesityDiureticsContinuous positive airway pressure

Clinical Trial Acronyms

ALLHAT

Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial

ASCOT-BPLA

Blood Pressure Lowering Arm of the Anglo-Scandinavian Cardiac Outcomes Trial

SHHS

Sleep Heart Health Study

WSCS

Wisconsin Sleep Cohort Study

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Stephen K. Williams
    • 1
    • 2
  • Joseph Ravenell
    • 1
  • Girardin Jean-Louis
    • 3
    • 4
  • Ferdinand Zizi
    • 3
    • 4
  • James A. Underberg
    • 5
  • Samy I. McFarlane
    • 3
    • 6
  • Gbenga Ogedegbe
    • 1
  1. 1.Center for Healthful Behavior Change, Division of General Internal MedicineNew York University School of MedicineNew YorkUSA
  2. 2.Center for Complementary and Integrative Medicine and Division of General Internal MedicineWeill Medical College of Cornell UniversityNew YorkUSA
  3. 3.Brooklyn Health Disparities Center, Department of MedicineSUNY Downstate Medical CenterBrooklynUSA
  4. 4.Sleep Disorders Center, Department of MedicineSUNY Downstate Medical CenterBrooklynUSA
  5. 5.NYU Center for Cardiovascular Prevention, Division of General Internal MedicineNew York University Medical SchoolNew YorkUSA
  6. 6.Division of Endocrinology, Diabetes, and Hypertension, Department of MedicineState University of New York, Downstate Medical Center and Kings County Hospital CenterBrooklynUSA