There is consistent epidemiological evidence that sleep disordered breathing and systemic arterial hypertension are deeply associated, being linked through a bidirectional complex interaction among multiple mechanisms including autonomic nervous system alterations, inflammation, hormonal and hemodynamic components, sleep alterations. However there are several unanswered questions not only from a pathophysiological perspective, but also regarding the effects of obstructive sleep apnea (OSA) treatment on arterial blood pressure values. At present, while many studies have supported the possibility to obtain at least a small blood pressure reduction with OSA treatment, in particular in hypertensive patients, large trials have not clearly confirmed a beneficial effect of this intervention on several cardiovascular endpoints such as mortality. Aim of the present review is to address the relationship between OSA and hypertension in the light of the latest evidence in the field. Moreover we will discuss future research topics to better clarify still pending issues pointing out the importance to obtain an early diagnosis, a more suitable phenotyping including comorbidities, and strategies to improve patients' compliance and adherence to treatment.
Lombardi, C., Pengo, M., Parati, G. (2018). Systemic hypertension in obstructive sleep apnea. JOURNAL OF THORACIC DISEASE, 10(Suppl 34), S4231-S4243 [10.21037/jtd.2018.12.57].
Systemic hypertension in obstructive sleep apnea
Lombardi, Carolina;Pengo, Martino F;Parati, Gianfranco
2018
Abstract
There is consistent epidemiological evidence that sleep disordered breathing and systemic arterial hypertension are deeply associated, being linked through a bidirectional complex interaction among multiple mechanisms including autonomic nervous system alterations, inflammation, hormonal and hemodynamic components, sleep alterations. However there are several unanswered questions not only from a pathophysiological perspective, but also regarding the effects of obstructive sleep apnea (OSA) treatment on arterial blood pressure values. At present, while many studies have supported the possibility to obtain at least a small blood pressure reduction with OSA treatment, in particular in hypertensive patients, large trials have not clearly confirmed a beneficial effect of this intervention on several cardiovascular endpoints such as mortality. Aim of the present review is to address the relationship between OSA and hypertension in the light of the latest evidence in the field. Moreover we will discuss future research topics to better clarify still pending issues pointing out the importance to obtain an early diagnosis, a more suitable phenotyping including comorbidities, and strategies to improve patients' compliance and adherence to treatment.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.