Obstructive sleep apnea/hypopnea and systemic hypertension
Joaquín Durán-Cantolla1, Felipe Aizpuru, Cristina Martínez-Null
1Unidad de Trastornos del Sueño, Hospital Txagorritxu, Universidad del País Vasco, C/ José Achótegui s/n, E-01009 Vitoria-Gasteiz, Alava, Spain. Joaquin.durancantolla@gmail.com
Sleep Medicine Reviews
|June 12, 2009
Summary
Obstructive sleep apnea (OSAH) is common and linked to hypertension. Continuous positive airway pressure (CPAP) therapy can significantly lower blood pressure, especially in severe cases, reducing cardiovascular risks.
Area of Science:
- Cardiology
- Pulmonology
- Sleep Medicine
Background:
- Obstructive sleep apnea/hypopnea (OSAH) is a prevalent condition with significant public health implications.
- OSAH is strongly associated with hypertension and contributes to cardiovascular events, reduced quality of life, and accidents.
- Despite its prevalence, OSAH is underdiagnosed and undertreated, affecting 2-6% of the population.
Purpose of the Study:
- To review the evidence on the impact of continuous positive airway pressure (CPAP) on blood pressure in patients with OSAH.
- To evaluate the clinical significance of CPAP-induced blood pressure reduction for cardiovascular risk.
- To identify potential indicators for CPAP treatment efficacy in hypertensive OSAH patients.
Main Methods:
- Systematic review and meta-analysis of controlled studies on CPAP treatment for OSAH.
- Analysis of blood pressure changes in OSAH patients undergoing CPAP therapy.
- Assessment of cardiovascular and cerebrovascular risk reduction associated with BP lowering.
Main Results:
- CPAP treatment results in a significant reduction in blood pressure, averaging approximately 2 mm Hg.
- The blood pressure-lowering effect of CPAP is more pronounced in hypertensive individuals and those with severe OSAH.
- This reduction in blood pressure is clinically meaningful for mitigating cardiovascular and cerebrovascular risks.
Conclusions:
- CPAP therapy is an effective intervention for reducing blood pressure in patients with OSAH, particularly those who are hypertensive.
- Treatment with CPAP may be considered for patients with severe OSAH and hypertension, even if asymptomatic.
- Further research is needed to identify biomarkers that predict blood pressure response to CPAP, optimizing clinical application.
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