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Refractory hypertension and obstructive sleep apnea.
Grace Oscullo1,2,3, Martino F Pengo4,5, Jose Daniel Gómez-Olivas1,2,3
1Pneumology Department, Hospital Universitario y Politécnico La Fe. Valencia. Spain.
Journal of Hypertension
|October 2, 2025
Summary
Refractory hypertension (RfH) is linked to sleep apnea syndrome (OSA). Treating OSA with CPAP significantly lowers blood pressure in RfH patients, improving cardiovascular risk.
Area of Science:
- Cardiology
- Sleep Medicine
- Hypertension Research
Background:
- Refractory hypertension (RfH) is a severe form of high blood pressure with elevated cardiovascular risks, affecting 0.5-1% of hypertensive patients.
- Sleep apnea syndrome (OSA), characterized by airway obstruction during sleep, is highly prevalent globally.
- Both RfH and OSA involve sympathetic nervous system hyperactivation, suggesting a shared pathophysiological pathway.
Purpose of the Study:
- To investigate the clinical relationship between refractory hypertension and sleep apnea syndrome.
- To explore the impact of OSA treatment on blood pressure control in patients with RfH.
Main Methods:
- Observational studies and clinical trials examining patients with RfH.
- Assessment of OSA prevalence in RfH populations.
- Evaluation of blood pressure reduction following continuous positive airway pressure (CPAP) therapy for OSA in RfH patients.
Main Results:
- A high prevalence of OSA (80-90%) is observed in patients diagnosed with RfH.
- Continuous positive airway pressure (CPAP) treatment for OSA demonstrates a significant reduction in blood pressure, typically 8-10 mmHg, in patients with RfH.
- This suggests OSA may contribute to treatment resistance in hypertension.
Conclusions:
- Sleep apnea syndrome is a common comorbidity in patients with refractory hypertension.
- Effective treatment of OSA with CPAP can improve blood pressure control and potentially reduce cardiovascular risk in this patient group.
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