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OSA and Hypertension

Q. How does sleep apnea affect hypertension?

A. Sleep apnea results in periods of higher blood pressure, or hypertension, as the heart tries to counter the build-up of carbon dioxide by pumping harder. Increases in arterial pressures of 30 mm Hg or more are not uncommon. By contrast, adults who do not have sleep apnea will typically experience nighttime blood pressure drops of about 10%.

A recent study reported that sleep apnea treatment with CPAP (continuous positive air pressure) resulted in an average reduction of 10 mm Hg systolic and 4.5 mm Hg diastolic blood pressure. In contrast, CPAP had no measurable effect on nocturnal blood pressure in study participants with hypertension who did not have sleep apnea.

Recently, researchers at the University of Wisconsin Medical School established that sleep apnea is likely to be an important cause of hypertension. Results of their eight-year study involving more than 700 people were published in the New England Journal of Medicine. The researchers reported that even mild to moderate levels of sleep apnea produced a substantial risk of hypertension. They observed that the more severe the sleep apnea, the greater the likelihood of developing hypertension.

In the study, 709 participants, all randomly selected, were monitored in an overnight stay in a special sleep laboratory at University of Wisconsin Hospital. Researchers measured the number of episodes of breathing pauses each participant had during sleep to determine the presence and severity of sleep apnea. Five to fifteen pauses per hour represented mild to moderate sleep apnea; 15 or more pauses indicated moderate to severe sleep apnea. Participant health was reassessed four years later and in some cases eight years later as well.

The Wisconsin team statistically accounted for other factors related to hypertension—age, gender, weight, menopause, smoking, and alcohol use—but still found that sleep apnea played a significant and independent role in hypertension risk.

  • People with mild to moderate sleep apnea were twice as likely to become hypertensive.
  • People with moderate to severe sleep apnea were almost three times as likely to become hypertensive.

These Findings Tell Us That Doctors Should Take Seriously

ANY Symptoms or Signs of Sleep Apnea in Their Patients

 

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OSA and High Blood Pressure