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The Use of Precision Medicine to Manage Obstructive Sleep Apnea Treatment in Patients with Resistant Hypertension: Current Evidence and Future Directions

  • Esther Sapiña
  • Gerard Torres
  • Ferran Barbé
  • Manuel Sánchez-de-la-Torre
Resistant Hypertension (L Drager, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Resistant Hypertension

Abstract

Purpose of Review

The significant prevalence of resistant hypertension (RH) and the high cardiovascular risk of the population of patients with RH have indicated the necessity to identify its main causes. Among these, obstructive sleep apnea (OSA) is considered the most well-established cause.

Recent Findings

In recent years, several studies have shown a beneficial effect of continuous positive airway pressure (CPAP) treatment on blood pressure (BP), but this effect exhibits great variability. The diagnosis and management of OSA in patients with RH suggest a clinical option for a phenotype of patients for whom therapeutic strategies are limited to pharmaceutical therapy and renal denervation. However, the great variability in the CPAP response has increased the necessity to develop instruments to identify patients who could benefit from a treatment that reduces BP.

Summary

Application of precision medicine to these patients should be considered as a first-line intervention to avoid the prescription of ineffective treatments and excessive consumption of pharmacological drugs that do not ameliorate the cardiovascular risk.

Keywords

Resistant hypertension OSA Personalized medicine CPAP Cardiovascular disease 

Notes

Funding

Supported by the following: Fondo de Investigación Sanitaria (Fondo Europeo de Desarrollo Regional (FEDER) (PI14/01266; PI16/00489; DTS15/00145)), the Spanish Respiratory Society (SEPAR), Young Researchers Award from the AstraZeneca Foundation, and ALLER.

Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflict of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Esther Sapiña
    • 1
    • 2
  • Gerard Torres
    • 1
  • Ferran Barbé
    • 1
    • 2
  • Manuel Sánchez-de-la-Torre
    • 1
    • 2
  1. 1.Respiratory DepartmentHospital Universitari Arnau de Vilanova-Santa Maria, IRBLleidaLleidaSpain
  2. 2.Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES)MadridSpain

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