Obstructive Sleep Apnea and Hypertension: Why Treatment Does Not Consistently Improve Blood Pressure

Curr Hypertens Rep. 2019 Apr 4;21(4):30. doi: 10.1007/s11906-019-0935-x.

Abstract

Purpose of review: Obstructive sleep apnea (OSA) and hypertension are two phenomena deeply linked together and, although a causal relationship has been suggested, a recent meta-analysis showed only a very modest effect of OSA treatment on blood pressure (BP). However, a vast number of randomized controlled trials published so far share some limitations, mainly of methodological nature: neither OSA nor BP is always assessed in a standardized way. Moreover, compliance with OSA treatment is often sub-optimal making the results of these trials difficult to interpret.

Recent findings: Recent studies have shown that antihypertensive drugs can reduce BP more than OSA treatment, showing a better compliance profile and very few side effects. Considering the importance of reducing the overall cardiovascular risk of OSA patients, a more careful management of patient's antihypertensive medication could allow a better BP control also in this condition. In addition, greater efforts should be made to improve patient's acceptance of OSA treatment with the aim of improving their compliance.

Keywords: Blood pressure; Continuous positive airway pressure; Hypertension; Mandibular advancement device; Obstructive sleep apnea.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Humans
  • Hypertension / prevention & control*
  • Randomized Controlled Trials as Topic
  • Sleep Apnea, Obstructive / therapy*
  • Treatment Outcome

Substances

  • Antihypertensive Agents