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(Hypertension. 2008;51:605.)
© 2008 American Heart Association, Inc.

Hypertension Highlights

Sleep Apnea and Hypertension: Interactions and Implications for Management

From the Department of Internal Medicine (S.K.) and Division of Cardiovascular Diseases (F.H.S.K., V.K.S.), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Correspondence to Virend K. Somers, Mayo Clinic, Division of Cardiovascular Diseases, 200 First St, SW, Rochester, MN 55905. E-mail somers. virend@mayo.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Obstructive sleep apnea (OSA) is highly prevalent in the United States, with an estimated 1 in 4 Americans at risk for OSA. In recent years, there has been a large body of work assessing the role of OSA as an independent risk factor for hypertension. Certain patient characteristics, such as age and the type of elevated blood pressure, may confer increased likelihood that the hypertension is secondary to underlying sleep apnea. Furthermore, early diagnosis and treatment of OSA may be beneficial in the management of hypertensive patients, particularly in those with poorly controlled hypertension. The focus of this brief review is on recent developments in the characteristics and treatment of sleep apnea-associated hypertension. Because of space limitations, only limited references are provided.

	Interdependence Between OSA and Hypertension

 
The seventh report of the Joint National Committee identified OSA as an important identifiable cause of hypertension. As many as half of all patients with sleep apnea may have underlying hypertension, and many patients with hypertension, particularly resistant hypertension, may have OSA. In fact, there seems to be an interaction between OSA severity and resistance to antihypertensive medications.¹ Elevated nocturnal blood pressure and reduced blood pressure "dipping" during sleep also suggest a higher likelihood of underlying sleep apnea, even in normotensive patients. Whether hypertension contributes to OSA remains unknown.

	Systolic and Diastolic Hypertension

 
OSA patients may not always exhibit elevated systolic pressures but may have a high prevalence of isolated diastolic hypertension.^2–4 One study suggested that there was a significant association between the incidence of combined systolic and diastolic hypertension and the . . . [Full Text of this Article]

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