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Acupoint Application Combined with Ear Plaster Therapy for Treating Sleep Disorders with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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Resistant hypertension and obstructive sleep apnea.

Akram Khan¹, Nimesh K Patel, Daniel J O'Hearn

¹Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland OR & Portland VA Medical Center, 3181 SW Sam Jackson Park Road, UHN67, Portland, Oregon 97239-3098, USA.

International Journal of Hypertension

|June 20, 2013

Summary

Obstructive sleep apnea (OSA) is linked to resistant hypertension. Treating OSA with continuous positive airway pressure (CPAP) may help lower blood pressure and reduce cardiovascular risk.

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Area of Science:

Cardiology
Nephrology
Sleep Medicine

Background:

Hypertension (HTN) affects one in three US adults and is a major cause of cardiovascular and renal disease.
Resistant HTN is defined as uncontrolled blood pressure despite lifestyle changes and three antihypertensive medications.
Obstructive sleep apnea (OSA) is increasingly recognized as a significant risk factor for resistant HTN.

Purpose of the Study:

To review the association between OSA and resistant HTN.
To explore the physiological mechanisms linking OSA to resistant HTN.
To discuss the impact of continuous positive airway pressure (CPAP) therapy on blood pressure in resistant HTN patients.

Main Methods:

Literature review of studies investigating the relationship between OSA and resistant HTN.
Analysis of proposed pathophysiological mechanisms.
Evaluation of evidence regarding CPAP's efficacy in reducing blood pressure.

Main Results:

OSA is a prevalent risk factor for resistant HTN.
Mechanisms include intermittent hypoxia, hyperaldosteronism, sympathetic overactivity, endothelial dysfunction, and inflammation.
CPAP therapy typically yields modest, yet clinically significant, blood pressure reductions in OSA patients.

Conclusions:

Patients with resistant HTN should be screened for OSA.
Treating OSA is a crucial strategy for managing resistant HTN.
Addressing OSA can mitigate cardiovascular risk in hypertensive patients.