Effects of continuous positive airway pressure therapy on hypertension control in patients with sleep-related breathing disorders: available evidence and unresolved issues.

摘要

In the last decade, large epidemiological and prospective studies have shown an independent association between obstructive sleep apnea (OSA) and hypertension [1-4]. Also based on experimental animal models [5,6], complex interactions among OSA, sympathetic activation, increase in plasma aldosterone levels, and blood pressure (BP) changes have been proposed as possible mediators for this association [7-9]. In particular, a few small epidemiological studies have shown a strong association between drug-resistant hypertension and OSA [7,10-12]. Based on such evidence, the seventh report of the Joint National Committee in United States (JNC VII recommendations [13]) and the 2007 European Society of Cardiology-European Society of Hypertension guidelines [14], first acknowledged OSA as an important identifiable cause of hypertension and, more specifically, as one of the factors responsible for resistant hypertension.