Obstructive sleep apnea (OSA) is a prevalent sleep disorder as is hypertension (HTN) in the 21st century with the rising incidence of obesity. Numerous studies have shown a strong association of OSA with cardiovascular morbidity and mortality. There is overwhelming evidence supporting the relationship between OSA and hypertension (HTN). The pathophysiology of HTN in OSA is complex and dependent on various factors such as sympathetic tone, renin-angiotensin-aldosterone system, endothelial dysfunction, and altered baroreceptor reflexes. The treatment of OSA is multifactorial ranging from CPAP to oral appliances to lifestyle modifications to antihypertensive drugs. OSA and HTN both need prompt diagnosis and treatment to help address the growing cardiovascular morbidity and mortality due to these two entities.

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cardiovascular events than brachial pressure. Proportion of patients not at goal blood pressure is astounding. The aim of this study was to identify patients with hypertension not achieving goal brachial blood pressure and to investigate the co-relation between brachial blood pressure and central systolic blood pressure by using Pulse Wave Analysis (PWA). METHODS: We conducted a single center, prospective, cohort study at the Outpatient Nephrology clinic operated by West Virginia University Hospitals between January 2017 and February 2018. RESULTS: 22 patients met the inclusion criteria for the study, however only 14 (63.6%) followed through with getting at least one follow up PWA testing. 7/14 (50%) were males. 12/14 (85.7%) were older than 60 yrs. 10/14 (71.4%) had elevated central systolic pressures and pulse pressures at the initial visit and 2/14 (14.3%) an elevated augmented index. At the end of the study 9/14 (64.2%) were at goal central systolic blood pressure, 6/14 (42.9%) at goal Pulse pressure, with 8/14 (57.1%) at goal augmented index. At study end there was on average a 8.2 mmHg decrease in the central systolic pressure and 9.8 mmHg reduction in the pulse pressure after the lifestyle and anti-hypertensive regimen modification. CONCLUSION: Our results showed a predominantly elderly and obese population. Discrepancies between brachial and central systolic blood pressure may exist. Patients may benefit from the management of their blood pressure with the use of central blood pressure, pulse pressure and augmented index measurements as obtained by the Atcor Medical XCEL Pulse wave analysis machine. Further studies are needed to reinforce the importance of the utility of Pulse wave analysis and central blood pressure monitoring in the treatment of hypertension.

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