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

  • Gianfranco ParatiEmail author
  • Martino Francesco Pengo
  • Carolina Lombardi
Sleep and Hypertension (S. Justin Thomas, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Sleep and Hypertension


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.


Obstructive sleep apnea Hypertension Blood pressure Continuous positive airway pressure Mandibular advancement device 


Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Gianfranco Parati
    • 1
    • 2
    Email author
  • Martino Francesco Pengo
    • 1
  • Carolina Lombardi
    • 1
    • 2
  1. 1.Sleep Disorder Centre, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca HospitalIRCCS Istituto Auxologico ItalianoMilanItaly
  2. 2.Department of Medicine and SurgeryUniversity of Milano-BicoccaMilanItaly

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