A Critical Review on Management of Hypertension in Obstructive Sleep Apnea

Abstract

Obstructive sleep apnea (OSA) is an underdiagnosed condition associated with essential hypertension (HTN), resistant HTN (r-HTN), and cardiovascular disease (CVD). The purpose of this review is to provide an update on HTN and its association with OSA. As obesity increases in the 21st century, OSA and HTN are common sleep disorders. OSA has been linked to cardiovascular morbidity and mortality in numerous studies. It is well established that OSA and HTN are associated. Various factors contribute to HTN in OSA, such as sympathetic tone, renin-angiotensin-aldosterone system dysfunction, endothelial dysfunction, and altered baroreceptor reflexes. A multifactorial approach to treating OSA involves Continuous positive airway pressure (CPAP), oral appliances, lifestyle modification, and antihypertensive medications. Both OSA and HTN must be diagnosed and treated promptly in order to help address the growing burden of cardiovascular morbidity and mortality caused by these two conditions.