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The Use of Precision Medicine to Manage Obstructive Sleep Apnea Treatment in Patients with Resistant Hypertension: Current Evidence and Future Directions

  • Resistant Hypertension (L Drager, Section Editor)
  • Published:
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Abstract

Purpose of Review

The significant prevalence of resistant hypertension (RH) and the high cardiovascular risk of the population of patients with RH have indicated the necessity to identify its main causes. Among these, obstructive sleep apnea (OSA) is considered the most well-established cause.

Recent Findings

In recent years, several studies have shown a beneficial effect of continuous positive airway pressure (CPAP) treatment on blood pressure (BP), but this effect exhibits great variability. The diagnosis and management of OSA in patients with RH suggest a clinical option for a phenotype of patients for whom therapeutic strategies are limited to pharmaceutical therapy and renal denervation. However, the great variability in the CPAP response has increased the necessity to develop instruments to identify patients who could benefit from a treatment that reduces BP.

Summary

Application of precision medicine to these patients should be considered as a first-line intervention to avoid the prescription of ineffective treatments and excessive consumption of pharmacological drugs that do not ameliorate the cardiovascular risk.

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Funding

Supported by the following: Fondo de Investigación Sanitaria (Fondo Europeo de Desarrollo Regional (FEDER) (PI14/01266; PI16/00489; DTS15/00145)), the Spanish Respiratory Society (SEPAR), Young Researchers Award from the AstraZeneca Foundation, and ALLER.

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Author notes

  1. Esther Sapiña and Gerard Torres contributed equally to this work.

Authors and Affiliations

  1. Respiratory Department, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain

    Esther Sapiña, Gerard Torres, Ferran Barbé & Manuel Sánchez-de-la-Torre

  2. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain

    Esther Sapiña, Ferran Barbé & Manuel Sánchez-de-la-Torre

Authors
  1. Esther Sapiña
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  2. Gerard Torres
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  4. Manuel Sánchez-de-la-Torre
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Correspondence to Manuel Sánchez-de-la-Torre.

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This article is part of the Topical Collection on Resistant Hypertension

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Sapiña, E., Torres, G., Barbé, F. et al. The Use of Precision Medicine to Manage Obstructive Sleep Apnea Treatment in Patients with Resistant Hypertension: Current Evidence and Future Directions. Curr Hypertens Rep 20, 60 (2018). https://doi.org/10.1007/s11906-018-0853-3

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