Skip to main content

Part of the book series: Practical Case Studies in Hypertension Management ((PCSHM))

  • 755 Accesses

Abstract

A 65-year-old, Caucasian male, diagnosed of hypertension at 60 years of age, was referred by his family physician to evaluate uncontrolled hypertension. He was treated with three antihypertensive drugs. He reports symptoms of morning headache, diurnal sleepiness and snoring. 24-h ambulatory blood pressure monitoring (ABPM) was performed, and the final diagnosis was uncontrolled hypertension. A polysomnographic study confirmed a severe obstructive sleep apnoea syndrome (OSA).

International guidelines now recognize OSA as one of the most common risk factors of resistant hypertension.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.

    Google Scholar 

  2. Pavlova MK, Duffy JF, Shea SA. Polysomnographic respiratory abnormalities in asymptomatic individuals. Sleep. 2008;31:241–8.

    Google Scholar 

  3. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342:1378–84.

    Google Scholar 

  4. Logan AG, Perlikowski SM, Mente A, Tisler A, Tkacova R, et al. High prevalence of unrecognized sleep apnea in drug-resistant hypertension. J Hypertens. 2001;19:2271–7.

    Google Scholar 

  5. Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension. 2008;51:1403–19.

    Google Scholar 

  6. Sánchez-de-la-Torre M, Campos-Rodriguez F, Barbé F. Obstructive sleep apnoea and cardiovascular disease. Lancet Respir Med. 2013;1:61–72.

    Google Scholar 

  7. Coccagna G, Mantovani M, Brignani F, Parchi C, Lugaresi E. Continuous recording of the pulmonary and systemic arterial pressure during sleep in syndromes of hypersomnia with periodic breathing. Bull Physiopathol Respir (Nancy). 1972;8:1159–72.

    Google Scholar 

  8. O’Brien E, Parati G, Stergiou G, Asmar R, Beilin L, Bilo G, et al., on behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension Position Paper on ambulatory blood pressure monitoring. J Hypertens. 2013;31:1731–68.

    Google Scholar 

  9. Javaheri S, Barbe F, Campos-Rodriguez F, Dempsey JA, Khayat R, Javaheri S, et al. Types, mechanisms and clinical cardiovascular consequences. J Am Coll Cardiol. 2017;69:841–58.

    Google Scholar 

  10. Pedrosa RP, Drager LF, De Paula LKG, Amaro ACS, Bortolotto LA, Lorenzi-Filho G. Effects of OSA treatment on BP in patients with resistant hypertension: a randomized trial. Chest. 2013;144:1487–94.

    Google Scholar 

  11. Lozano L, Tovar JL, Sampol G, Romero O, Jurado MJ, Segarra A, et al. Continuous positive airway pressure treatment in sleep apnea patients with resistant hypertension: a randomized, controlled trial. J Hypertens. 2010;28:2161–8.

    Google Scholar 

  12. Muxfeldt ES, Margallo V, Costa LMS, Guimaraes G, Cavalcante AH, Azevedo JCM, et al. Effects of continuous positive airway pressure treatment on clinic and ambulatory blood pressures in patients with obstructive sleep apnea and resistant hypertension. Hypertension. 2015;65:736–42.

    Google Scholar 

  13. Iftikhar IH, Valentine CW, Bittencourt LRA, Cohen DL, Fedson AC, Gislason T, et al. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertens. 2014;32:2341–50.

    Google Scholar 

  14. Martínez-García MA, Capote F, Campos-Rodríguez F, Lloberes P, Diaz de Atauri MJ, Somoza M, et al. Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension the HIPARCO randomized clinical trial. JAMA. 2013;310:2407–15.

    Google Scholar 

  15. Thunström E, Manhem K, Rosengren A, Peker Y. Blood pressure response to losartan and continuous positive airway pressure in hypertension and obstructive sleep apnea. Am J Respir Crit Care Med. 2016;193:310–20.

    Google Scholar 

  16. Chirinos JA, Gurubhagavatula I, Teff K, Rader DJ, Wadden TA, Townsend R, et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med. 2014;370:2265–75.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Segura, J. (2019). Patient with Hypertension and OSA. In: Hypertension and 24-hour Ambulatory Blood Pressure Monitoring. Practical Case Studies in Hypertension Management. Springer, Cham. https://doi.org/10.1007/978-3-030-02741-4_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-02741-4_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-02740-7

  • Online ISBN: 978-3-030-02741-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics