Obstructive sleep apnea and hypertension; critical overview.

Area of Science:

• Cardiology
• Sleep Medicine
• Public Health

Background:

• Obstructive sleep apnea (OSA) and hypertension are critical modifiable risk factors for cardiovascular disease.
• The relationship between OSA and hypertension is complex and bidirectional.
• Understanding this interplay is crucial for effective cardiovascular risk management.

Purpose of the Study:

• To critically review the literature on OSA as a risk factor for hypertension.
• To examine the effects of OSA on blood pressure (BP) and BP variability (BPV).
• To discuss the impact of continuous positive airway pressure (CPAP) treatment on BP and cardiovascular outcomes, considering ethnicity and social determinants.

Main Methods:

• Literature review of current research on OSA and hypertension.
• Analysis of studies investigating nocturnal BP, BP response to CPAP, and BP variability in OSA patients.
• Examination of data on ethnicity, social determinants of health, and cardiovascular outcomes in Asian populations.

Main Results:

• OSA significantly affects nocturnal BP and contributes to hypertension.
• CPAP treatment can improve BP control, even in cases of refractory hypertension.
• OSA is linked to increased BP variability and maladaptive cardiac remodeling.
• Ethnicity and social determinants of health, particularly in Asian populations, influence OSA prevalence, BP control, and cardiovascular outcomes.

Conclusions:

• OSA is a significant, modifiable risk factor for hypertension and cardiovascular disease.
• Effective management of OSA, including CPAP therapy, is essential for BP control and reducing cardiovascular risk.
• Further research is needed to address disparities in BP control and outcomes related to ethnicity and social determinants in OSA patients.