Obstructive sleep apnea and hypertension

Curr Hypertens Rep. 2010 Jun;12(3):189-95.


Calhoun DA.

Vascular Biology and Hypertension Program, Sleep/Wake Disorders Center, University of Alabama at Birmingham, 430 BMR2, 1530 3rd Avenue South, Birmingham, AL 35294-2180, USA. dcalhoun@uab.edu

Abstract

Obstructive sleep apnea (OSA) and hypertension commonly coexist. Observational studies indicate that untreated OSA is associated with an increased risk of prevalent hypertension, whereas prospective studies of normotensive cohorts suggest that OSA may increase the risk of incident hypertension. Randomized evaluations of continuous positive airway pressure (CPAP) indicate an overall modest effect on blood pressure. However, these studies do indicate a wide variation in the blood pressure effects of CPAP, with some patients, on an individual basis, manifesting a large antihypertensive benefit. OSA is particularly common in patients with resistant hypertension. The reason for this high prevalence of OSA is not fully explained, but data from our laboratory suggest that it may be related to the high occurrence of hyperaldosteronism in patients with resistant hypertension. We hypothesize