Uncontrolled hypertension and obstructive sleep apnea: integrated treatment approach
https://doi.org/10.38109/2075-082X-2022-3-41-47
Abstract
The main goal in the arterial hypertension (AH) management is the target blood pressure (BP) achievement, as it leads to the cardiovascular risk reduction. At the same time, proper BP is achieved less than in 50% of all cases. In addition, there are two types of truly uncontrolled AH in population, such as resistant (RAH) and refractory (RFH) AH.
Recent research suggests that RAH may be associated with changes in the renin-angiotensin-aldosterone system, while RFH appears to be more closely associated with sympathetic hyperactivation. These pathophysiological mechanisms are also active in patients with obstructive sleep apnea (OSA). Therefore, the prevalence of OSA in patients with RAH and RFH is very high, and treatment with continuous positive airway pressure (PAP-therapy) can reduce BP levels in such patients. The latter allows us to consider PAP-therapy as an additional method for the target BP achievement in patients with uncontrolled AH and OSA.
About the Authors
O. O. Mikhailova
E.I. Chazov National Medical Research Center of Cardiology
Russian Federation
Russian Federation
Oksana O. Mikhailova, Cand. Sci. (Med.), Researcher of the Sleep Laboratory, Hypertension Department
3rd Cherepkovskaya str., 15a, Moscow 121552
K. O. Gogiberidze
E.I. Chazov National Medical Research Center of Cardiology
Russian Federation
Russian Federation
Kristina O. Gogiberidze, resident of the Hypertension Department
3rd Cherepkovskaya str., 15a, Moscow 121552
E. M. Elfimova
E.I. Chazov National Medical Research Center of Cardiology
Russian Federation
Russian Federation
Evgeniya M. Elfimova, Cand. Sci. (Med.), Senior Researcher of the Sleep Laboratory, Hypertension Department
3rd Cherepkovskaya str., 15a, Moscow 121552
A. Yu. Litvin
E.I. Chazov National Medical Research Center of Cardiology; Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Alexandr Yu. Litvin, Dr. Sci. (Med.), Prof., Chief of the Sleep Laboratory, Hypertension Department; professor of the department
3rd Cherepkovskaya str., 15a, Moscow 121552
Ostrovitianov str. 1, Moscow, 117997
I. E. Chazova
E.I. Chazov National Medical Research Center of Cardiology
Russian Federation
Russian Federation
Irina E. Chazova, Dr. Sci. (Med.), Prof., Acad. RAS, Chief of the Hypertension Department
3rd Cherepkovskaya str., 15a, Moscow 121552
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Mikhailova O.O., Gogiberidze K.O., Elfimova E.M., Litvin A.Yu., Chazova I.E. Uncontrolled hypertension and obstructive sleep apnea: integrated treatment approach. Systemic Hypertension. 2022;19(3):41-47. (In Russ.) https://doi.org/10.38109/2075-082X-2022-3-41-47
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