open access

Vol 19, No 2 (2015)
REVIEV
Published online: 2015-06-24
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Resistant hypertension and obstructive sleep apnea

Beata Krasińska, Szczepan Cofta, Angelika Miazga, Ludwina Szczepaniak-Chicheł, Tomasz Trafas, Zbigniew Krasiński, Andrzej Tykarski
DOI: 10.5603/AH.2015.0013
·
Arterial Hypertension 2015;19(2):95-100.

open access

Vol 19, No 2 (2015)
REVIEV
Published online: 2015-06-24

Abstract

Obstructive sleep apnea (OSA) remains one of the most common causes of resistant arterial hypertension (AH). Association between resistant hypertension and OSA was observed in numerous trials. In patients suffering from OSA resistant AH occurs in 37–56% of cases, while prevalence of OSA in group of patients suffering from resistant AH is as much as 70–85%. Presumably pathogenesis of resistant hypertension is determined by coexistence of several mechanisms. The key role in that process plays hypoxia which leads to sympathetic nervous system stimulation, activation of renin-angiotensin system, increase of oxydative stress and endothelin production. Activation of renin-angiotensin system with increase in angiotensin II and aldosterone concentrations leads to rise in peripheral vascular resistance, and in consequence increased afterload. Coexistence of OSA diminishes effectiveness of hypotensive treatment. In order to achieve blood pressure control it is necessary to use simultaneously several antihypertensive agents with different mechanism of action, including a diuretic.

Abstract

Obstructive sleep apnea (OSA) remains one of the most common causes of resistant arterial hypertension (AH). Association between resistant hypertension and OSA was observed in numerous trials. In patients suffering from OSA resistant AH occurs in 37–56% of cases, while prevalence of OSA in group of patients suffering from resistant AH is as much as 70–85%. Presumably pathogenesis of resistant hypertension is determined by coexistence of several mechanisms. The key role in that process plays hypoxia which leads to sympathetic nervous system stimulation, activation of renin-angiotensin system, increase of oxydative stress and endothelin production. Activation of renin-angiotensin system with increase in angiotensin II and aldosterone concentrations leads to rise in peripheral vascular resistance, and in consequence increased afterload. Coexistence of OSA diminishes effectiveness of hypotensive treatment. In order to achieve blood pressure control it is necessary to use simultaneously several antihypertensive agents with different mechanism of action, including a diuretic.

Get Citation

Keywords

arterial hypertension, resistant hypertension, obstructive sleep apnea (OSA)

About this article
Title

Resistant hypertension and obstructive sleep apnea

Journal

Arterial Hypertension

Issue

Vol 19, No 2 (2015)

Pages

95-100

Published online

2015-06-24

DOI

10.5603/AH.2015.0013

Bibliographic record

Arterial Hypertension 2015;19(2):95-100.

Keywords

arterial hypertension
resistant hypertension
obstructive sleep apnea (OSA)

Authors

Beata Krasińska
Szczepan Cofta
Angelika Miazga
Ludwina Szczepaniak-Chicheł
Tomasz Trafas
Zbigniew Krasiński
Andrzej Tykarski

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