Relationship Between OSA and Hypertension

Torres, Gerard; Sánchez‐de‐la‐Torre, Manuel; Barbé, Ferrán

doi:10.1378/chest.15-0136

Cited by 135 publications

(86 citation statements)

References 74 publications

(37 reference statements)

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“…Previously, a substantial number of observational researches have shown that patients with hypertension and OSA were more difficult to have their BP control than hypertensive patients without OSA67, and the underlying mechanisms might be partly attributed to intermittent hypoxemia-induced renin-angiotensin-aldosterone system activation8. Increased plasma aldosterone concentration (PAC) subsequently resulted in sodium and fluid accumulation in neck tissue during sleep which caused upper airway obstruction and OSA910.…”

mentioning

confidence: 99%

Association of aldosterone excess and apnea-hypopnea index in patients with resistant hypertension

Guo

et al. 2017

Sci Rep

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The present study was to investigate the association of aldosterone excess and apnea-hypopnea index (AHI) in patients with resistant hypertension. Patients with resistant hypertension were enrolled and baseline characteristics including plasma aldosterone concentration (PAC) and 24 h-urine aldosterone levels were collected and compared between groups with different degrees of AHI as assessed by polysomnography. Association of key variables and AHI was then evaluated by univariate and multiple linear regression analysis. A total of 534 patients with resistant hypertension were enrolled and mean age was 57 ± 11 years. Overall, mean number of AHI was 21.7 ± 9.6 and nearly 92.3% of resistant hypertensive patients had obstructive sleep apnea (OSA). Mean PAC and 24 h-urine aldosterone level was 12.4 ± 6.3 ng/dL and 13.1 ± 6.8 ug, respectively. Compared with other groups, participants in the severe OSA group (AHI ≥ 30) had significantly higher PAC and 24 h-urine aldosterone level. Multiple linear regression analysis showed that PAC and 24 h-urine aldosterone levels were positively associated with AHI, while spironolactone was negatively associated with AHI, independent of age, gender, body mass index, smoking, plasma renin activity and diuretics. OSA is highly prevalent in patients with resistant hypertension and both PAC and 24 h-urine aldosterone level are significantly associated with AHI.

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confidence: 99%

Association of aldosterone excess and apnea-hypopnea index in patients with resistant hypertension

Guo

et al. 2017

Sci Rep

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“…Inhibition of upper airway muscles, volume overload and rostral shift of fluid nocturnally can contribute to pharyngeal edema and the development of OSA in hypertensive patients. (114)…”

Section: Sleep Apnea and Cardiovascular Diseasementioning

confidence: 99%

Sleep

Grandner

Alfonso‐Miller

Fernández-Mendoza

et al. 2016

Current Opinion in Cardiology

120

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Purpose of Review Sleep plays many roles in maintenance of cardiovascular health. This review summarizes the literature across several areas of sleep and sleep disorders in relation to cardiometabolic disease risk factors. Current Findings Insufficient sleep duration is prevalent in the population and is associated with weight gain and obesity, inflammation, cardiovascular disease, diabetes, and mortality. Insomnia is also highly present and represents an important risk factor for cardiovascular disease, especially when accompanied by short sleep duration. Sleep apnea is a well-characterized risk factor for cardiometabolic disease and cardiovascular mortality. Other issues are relevant as well. For example, sleep disorders in pediatric populations may convey cardiovascular risks. Also, sleep may play an important role in cardiovascular health disparities. Summary Sleep and sleep disorders are implicated in cardiometabolic disease risk. This review addresses these and other issues, concluding with recommendations for research and clinical practice.

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“…In addition to improving cognitive performance, mood state, and quality of life, good sleep quality and enough sleep have a major impact on health conditions and life expectancy 1 . It has been demonstrated that short sleep duration is associated with hypertension, stroke, diabetes, and possibly other diseases 2 . Sleep can be disturbed by environmental conditions, such as noise, temperature, and humidity, and can be influenced by several psychiatric, neurological, or clinical disorders 3 .…”

Section: Introductionmentioning

confidence: 99%

Gel pillow designed specifically for obstructive sleep apnea treatment with continuous positive airway pressure

et al. 2016

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Objective:To determine whether the use of a gel pillow with side cutouts designed to accommodate a continuous positive airway pressure (CPAP) mask and reduce head temperature improves the efficacy of and adherence to auto-CPAP therapy. Methods:Twenty-three consecutive CPAP-naïve patients with obstructive sleep apnea were enrolled in the study. Patients were given an auto-CPAP machine with an appropriate CPAP mask and were instructed to use CPAP for 15 nights. They were instructed to sleep with their own pillow (the control pillow) from nights 1 to 5 and with either a foam pillow or a gel pillow, both of which had side cutouts, for 5 consecutive nights each, in random order. After night 15, auto-CPAP machine data were downloaded and patients rated their satisfaction with each pillow on a visual analog scale. Results:Twenty-two patients completed the protocol. The pressures administered, residual apnea-hypopnea index, air leaks, and mean duration of CPAP use did not differ among the periods during which each pillow was used. Patients were significantly more satisfied with the gel pillow than with the control pillow and the foam pillow (p = 0.022 and p = 0.004, respectively), their level of satisfaction with the gel pillow correlating significantly with excessive daytime sleepiness (r2 = 0.19; p = 0.0443). Conclusions:Among obstructive sleep apnea patients treated with nasal CPAP, the use of a gel pillow with side cutouts appears to have no impact on treatment effectiveness. Nevertheless, such patients seem to prefer a gel pillow over other types of pillows.

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Relationship Between OSA and Hypertension

Cited by 135 publications

References 74 publications

Association of aldosterone excess and apnea-hypopnea index in patients with resistant hypertension

Association of aldosterone excess and apnea-hypopnea index in patients with resistant hypertension

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Gel pillow designed specifically for obstructive sleep apnea treatment with continuous positive airway pressure

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