Matthew G Denker1, Debbie L Cohen. 1. Renal, Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Abstract
PURPOSE OF REVIEW: Obstructive sleep apnea (OSA) and hypertension are highly prevalent and treatable conditions that often coexist and both contribute to an increased cardiovascular risk. The ability of continuous positive airway pressure (CPAP) to improve blood pressure in hypertensive patients with OSA is debated. This review highlights findings from recent studies that have investigated the impact of CPAP on blood pressure in patients with OSA. RECENT FINDINGS: Comparing the results of various studies is complicated by important methodological differences among them. In hypertensive patients with OSA, treatment with CPAP improves blood pressure to a smaller degree than that derived from antihypertensive medication. Patients with more severe OSA and with greater adherence to CPAP are likely to gain the most benefit from the therapy. SUMMARY: CPAP should be used in combination with antihypertensive medications in hypertensive patients with OSA. CPAP has the additional benefits of restoring nocturnal dipping and improving arterial stiffness, thus potentially influencing cardiovascular morbidity in these high-risk patients.
PURPOSE OF REVIEW: Obstructive sleep apnea (OSA) and hypertension are highly prevalent and treatable conditions that often coexist and both contribute to an increased cardiovascular risk. The ability of continuous positive airway pressure (CPAP) to improve blood pressure in hypertensivepatients with OSA is debated. This review highlights findings from recent studies that have investigated the impact of CPAP on blood pressure in patients with OSA. RECENT FINDINGS: Comparing the results of various studies is complicated by important methodological differences among them. In hypertensivepatients with OSA, treatment with CPAP improves blood pressure to a smaller degree than that derived from antihypertensive medication. Patients with more severe OSA and with greater adherence to CPAP are likely to gain the most benefit from the therapy. SUMMARY: CPAP should be used in combination with antihypertensive medications in hypertensivepatients with OSA. CPAP has the additional benefits of restoring nocturnal dipping and improving arterial stiffness, thus potentially influencing cardiovascular morbidity in these high-risk patients.
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