Blood Pressure Regulation and Hypertension in Obstructive Sleep Apnea Syndrome: A Historical Perspective

Intern Med. 2024 Dec 1;63(23):3131-3136. doi: 10.2169/internalmedicine.2960-23. Epub 2024 Apr 16.

Abstract

In obstructive sleep apnea syndrome (OSAS), an underlying disease of secondary hypertension, repeated episodes of asphyxia due to obstructive sleep apnea (OSA), followed by arousal, lead to various cardiovascular consequences. Using a canine model of OSAS, it was found that a single load of OSA caused an abrupt increase in blood pressure (BP) (Apnea Surge in seconds), while multiple OSA episodes occurring nightly for 1-3 months led to a sustained elevation of BP during both nighttime and daytime. Epidemiological studies on 24-hour ambulatory BP measurements revealed that some hypertensive patients experienced elevated BP in the early morning (Morning Surge), which could be intensified by OSAS. The resonance of Apnea Surge in seconds and Morning Surge increases the risk of organ damage, triggers the cardiovascular events, and adversely affects the prognosis of hypertensive patients with OSAS. For ameliorating these risks, OSA should be treated with positive airway pressure properly.

Keywords: Morning Surge; apnea surge; blood pressure; hypertension; obstructive sleep apnea.

Publication types

  • Review
  • Historical Article

MeSH terms

  • Animals
  • Blood Pressure* / physiology
  • Dogs
  • History, 20th Century
  • Humans
  • Hypertension* / complications
  • Hypertension* / physiopathology
  • Sleep Apnea, Obstructive* / complications
  • Sleep Apnea, Obstructive* / physiopathology