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Bidirectional relationship of hypertension with obstructive sleep apnea
1aRenal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania bNephrology Division, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
Current Opinion in Pulmonary Medicine
|September 10, 2014
Summary
Hypertension and obstructive sleep apnea have a bidirectional relationship, where treating high blood pressure may improve sleep apnea symptoms. Further research is needed on hormonal mechanisms and antihypertensive effects.
Area of Science:
- Cardiology
- Sleep Medicine
- Nephrology
Background:
- Hypertension (HTN) and obstructive sleep apnea (OSA) frequently coexist and are linked to cardiovascular disease.
- OSA is a recognized risk factor for HTN, but this relationship may be bidirectional.
- Elevated blood pressure may increase the risk and severity of OSA.
Purpose of the Study:
- To review current literature on the bidirectional relationship between sleep apnea and hypertension.
- To explore how managing hypertension might impact OSA.
Main Methods:
- Literature review of studies examining the interplay between HTN and OSA.
- Analysis of mechanisms by which BP control could affect OSA.
Main Results:
- Lowering blood pressure targets in HTN treatment may improve OSA.
- Potential mechanisms include improved upper airway tone and modulation of hormonal pathways (aldosterone, renin-angiotensin system).
- Reduced nocturnal rostral fluid shifts via low-sodium diets, diuretics, or dialysis may also benefit OSA.
Conclusions:
- Intensive blood pressure and volume overload management show promise for treating OSA.
- Further investigation into hormonal pathways and comparative studies of antihypertensive medications on OSA are warranted.
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