Obstructive sleep apnea syndrome (OSAS) and hypertension: Pathogenic mechanisms and possible therapeutic approaches

Abstract

Obstructive sleep apnea syndrome (OSAS), a chronic condition characterized by collapse of the pharynx during sleep, has been increasingly recognized as a health issue of growing importance over the last decade. Recently emerging evidence suggests that there is a causal link between OSAS and hypertension, and hypertension represents an independent risk factor in OSAS patients. However, the pathophysiological basis for patients with OSAS having an increased risk for hypertension remains to be elucidated. The main acute physiological outcomes of OSAS are intermittent hypoxia, intrapleural pressure changes, and arousal from sleep, which might induce endothelial dysfunction, sympathetic activation, renin–angiotensin–aldosterone system activation, lipid metabolism dysfunction, and increased oxidative stress. This brief review focuses on the current understanding of the complex association between OSAS and hypertension.

Prevalence of hypertension and circadian blood pressure variations in patients with obstructive sleep apnoea–hypopnoea syndrome

“…10,11 In the present study, the prevalence of hypertension in all patients with OSAHS (50.5%) was significantly higher than that in controls (30.4%) and increased with the severity of OSAHS, which is consistent with previous reports. 2 In addition, AHI and LS a O 2 were closely related to BP values, with daytime, evening, night-time and morning MBP values rising with increasing AHI and decreasing LS a O 2 after controlling for related confounders.…”

High blood pressure in children attending pediatric clinic at King Abdulaziz University Hospital, Jeddah, Saudi Arabia

“…[18] The Bogalusa heart cohort study[29] concluded that low birth weight was significantly associated with the development of hypertension later in life. This is in accord with the finding in our study which revealed low birth weight as a significant predictor of prehypertension.…”

Prevalence of obstructive sleep apnoea in metabolic syndrome

“…18,19 Although studies have proven OSA as an independent risk for hypertension, present study demonstrates that severity of OSA correlates with severity of hypertension. 20,21 Severe hypertension was associated with higher AHI as compared to mild and moderate hypertension. Presently there are a couple of sets of defining criteria for metabolic syndrome set out by two different sources-the International Diabetes Federation and the revised National Cholesterol Education Program (NCEP).…”