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Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
Published on: June 6, 2025
745
Beyond Resistant Hypertension.
Miguel-Angel Martínez-García1, Cristina Navarro-Soriano1, Gerard Torres2
1From the Department of Pneumology, Hospital Universitario y Politécnico La Fe, Valencia, Spain (M.-A.M.-G., C.N.-S., M.J.S.-F., A.G.O.).
Hypertension (Dallas, Tex. : 1979)
|October 26, 2018
Summary
Patients with refractory hypertension (RfH) have a significantly higher prevalence and severity of obstructive sleep apnea (OSA) compared to those with resistant hypertension (RH). Early identification of OSA in RfH patients is crucial for timely referral to sleep units.
Area of Science:
- Cardiology
- Sleep Medicine
- Hypertension Research
Background:
- Obstructive sleep apnea (OSA) is a known independent cause of resistant hypertension (RH).
- The association between OSA and refractory hypertension (RfH), a severe form of hypertension, remains under-investigated.
- Understanding this link is critical for managing complex hypertensive patients.
Purpose of the Study:
- To analyze the association between OSA presence and severity with refractory hypertension (RfH).
- To compare OSA characteristics in patients with RfH versus those with RH.
- To highlight the clinical significance of identifying OSA in severe hypertension.
Main Methods:
- A multicenter, cross-sectional study involving 229 patients diagnosed with RH.
- Patients were categorized into true RfH (BP ≥130/80 mmHg despite ≥5 antihypertensives) and RH groups.
- All participants underwent sleep studies and provided detailed clinical histories; 42 patients met RfH criteria.
Main Results:
- Patients with RfH exhibited a higher cardiovascular risk profile and elevated blood pressure.
- RfH patients had a 2-fold greater risk of severe OSA (AHI ≥15) and OSA syndrome (AHI ≥5 + ESS >10).
- Mean apnea-hypopnea index (AHI) was significantly higher in the RfH group (41.8 vs. 33.8 events/h).
Conclusions:
- Refractory hypertension is strongly associated with a greater prevalence and severity of OSA and OSA syndrome.
- Patients with RfH demonstrate a significantly higher burden of OSA compared to RH patients.
- Preferential referral of RfH patients to sleep units is recommended for timely OSA diagnosis and management.
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