Relationship Between OSA and Hypertension.

Area of Science:

• Cardiology
• Pulmonology
• Sleep Medicine

Background:

• Obstructive Sleep Apnea (OSA) is bidirectionally associated with systemic hypertension.
• Factors like age, sex, and somnolence influence the OSA-hypertension relationship.
• OSA impacts 24-hour blood pressure (BP) circadian patterns, often leading to nondipping or riser patterns.

Purpose of the Study:

• To clarify the influence of OSA on nocturnal hypertension development.
• To explore the relationship between OSA and resistant hypertension.
• To evaluate the efficacy of treatments like CPAP and diuretics for hypertension in OSA patients.

Main Methods:

• Review of existing literature and meta-analyses on OSA and hypertension.
• Analysis of the impact of Continuous Positive Airway Pressure (CPAP) on BP.
• Consideration of diuretic therapy, particularly antialdosteronic agents, for OSA patients.

Main Results:

• OSA patients frequently exhibit nondipping or riser BP circadian patterns, linked to organ damage.
• A strong association exists between OSA and resistant hypertension, with CPAP showing a mild BP-lowering effect.
• CPAP's BP reduction is influenced by compliance, somnolence, and baseline BP.

Conclusions:

• Diuretics, especially antialdosteronic agents, are recommended as first-line treatment for OSA patients with hypertension.
• These diuretics may improve OSA severity by reducing edema and airway obstruction, thereby lowering BP.
• Further randomized controlled trials are needed to evaluate oral appliances for BP management in OSA.