Hypertension and obstructive sleep apnoea syndrome: current perspectives

Area of Science:

• Cardiology
• Pulmonology
• Sleep Medicine

Background:

• Obstructive sleep apnoea syndrome (OSAS) is a prevalent condition linked to upper airway collapse.
• A proven dose-response relationship exists between OSAS and hypertension (HT).
• Increased sympathetic activity during apnoeas is a primary mechanism linking OSAS and HT.

Purpose of the Study:

• To explore the characteristics of hypertension associated with OSAS.
• To investigate the diagnostic approaches for HT in OSAS patients.
• To evaluate the impact of OSAS treatment on associated hypertension.

Main Methods:

• Clinical blood pressure measurement.
• 24-hour ambulatory blood pressure monitoring (ABPM).
• Assessment of treatment response to nasal continuous positive airway pressure (nCPAP).

Main Results:

• HT in OSAS often presents with high prevalence, diastolic and nocturnal predominance, and frequent non-dipper status.
• OSAS is common in refractory HT and warrants systematic investigation.
• nCPAP treatment can reduce blood pressure in hypertensive OSAS patients, particularly if HT is severe or untreated.

Conclusions:

• Hypertension associated with OSAS frequently coexists with metabolic abnormalities, contributing to metabolic syndrome.
• nCPAP efficacy in lowering BP depends on OSAS severity and patient adherence.
• Optimal treatment strategies for HT in OSAS require further evidence; antihypertensives do not alter respiratory parameters in OSAS.