Obstructive sleep apnea and hypertension: Mechanisms,evaluation, and management |
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Authors: | John M Dopp Kevin J Reichmuth Barbara J Morgan |
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Institution: | (1) Department of Orthopedics and Rehabilitation, 1300 University Avenue, Madison, WI 53706, USA |
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Abstract: | Obstructive sleep apnea (OSA) is a recognized cause of secondary hypertension. OSA episodes produce surges in systolic and
diastolic pressure that keep mean blood pressure levels elevated at night. In many patients, blood pressure remains elevated
during the daytime, when breathing is normal. Contributors to this diurnal pattern of hypertension include sympathetic nervous
system overactivity and alterations in vascular function and structure caused by oxidant stress and inflammation. Treatment
of OSA with nasal continuous positive airway pressure (CPAP) abolishes apneas, thereby preventing intermittent arterial pressure
surges and restoring the nocturnal “dipping” pattern. CPAP treatment also has modest beneficial effects on daytime blood pressure.
Because even small decreases in arterial pressure can contribute to reducing cardiovascular risk, screening for OSA is an
essential element of evaluating patients with hypertension. |
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Keywords: | |
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