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Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges
Hypertension is one of the most frequent cardiovascular risk factors. The population of hypertensive patients includes some phenotypes whose blood pressure levels are particularly difficult to control, thus putting them at greater cardiovascular risk. This is especially true of so-called resistant h...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912579/ https://www.ncbi.nlm.nih.gov/pubmed/31694223 http://dx.doi.org/10.3390/jcm8111872 |
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author | Oscullo, Grace Torres, Gerard Campos-Rodriguez, Francisco Posadas, Tomás Reina-González, Angela Sapiña-Beltrán, Esther Barbé, Ferrán Martinez-Garcia, Miguel Angel |
author_facet | Oscullo, Grace Torres, Gerard Campos-Rodriguez, Francisco Posadas, Tomás Reina-González, Angela Sapiña-Beltrán, Esther Barbé, Ferrán Martinez-Garcia, Miguel Angel |
author_sort | Oscullo, Grace |
collection | PubMed |
description | Hypertension is one of the most frequent cardiovascular risk factors. The population of hypertensive patients includes some phenotypes whose blood pressure levels are particularly difficult to control, thus putting them at greater cardiovascular risk. This is especially true of so-called resistant hypertension (RH) and refractory hypertension (RfH). Recent findings suggest that the former may be due to an alteration in the renin–angiotensin–aldosterone axis, while the latter seems to be more closely related to sympathetic hyper-activation. Both these pathophysiological mechanisms are also activated in patients with obstructive sleep apnoea (OSA). It is not surprising, therefore, that the prevalence of OSA in RH and RfH patients is very high (as reflected in several studies) and that treatment with continuous positive airway pressure (CPAP) manages to reduce blood pressure levels in a clinically significant way in both these groups of hypertensive patients. It is therefore necessary to incorporate into the multidimensional treatment of patients with RH and RfH (changes in lifestyle, control of obesity and drug treatment) a study of the possible existence of OSA, as this is a potentially treatable disease. There are many questions that remain to be answered, especially regarding the ideal combination of treatment in patients with RH/RfH and OSA (drugs, renal denervation, CPAP treatment) and patients’ varying response to CPAP treatment. |
format | Online Article Text |
id | pubmed-6912579 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-69125792020-01-02 Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges Oscullo, Grace Torres, Gerard Campos-Rodriguez, Francisco Posadas, Tomás Reina-González, Angela Sapiña-Beltrán, Esther Barbé, Ferrán Martinez-Garcia, Miguel Angel J Clin Med Review Hypertension is one of the most frequent cardiovascular risk factors. The population of hypertensive patients includes some phenotypes whose blood pressure levels are particularly difficult to control, thus putting them at greater cardiovascular risk. This is especially true of so-called resistant hypertension (RH) and refractory hypertension (RfH). Recent findings suggest that the former may be due to an alteration in the renin–angiotensin–aldosterone axis, while the latter seems to be more closely related to sympathetic hyper-activation. Both these pathophysiological mechanisms are also activated in patients with obstructive sleep apnoea (OSA). It is not surprising, therefore, that the prevalence of OSA in RH and RfH patients is very high (as reflected in several studies) and that treatment with continuous positive airway pressure (CPAP) manages to reduce blood pressure levels in a clinically significant way in both these groups of hypertensive patients. It is therefore necessary to incorporate into the multidimensional treatment of patients with RH and RfH (changes in lifestyle, control of obesity and drug treatment) a study of the possible existence of OSA, as this is a potentially treatable disease. There are many questions that remain to be answered, especially regarding the ideal combination of treatment in patients with RH/RfH and OSA (drugs, renal denervation, CPAP treatment) and patients’ varying response to CPAP treatment. MDPI 2019-11-05 /pmc/articles/PMC6912579/ /pubmed/31694223 http://dx.doi.org/10.3390/jcm8111872 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Oscullo, Grace Torres, Gerard Campos-Rodriguez, Francisco Posadas, Tomás Reina-González, Angela Sapiña-Beltrán, Esther Barbé, Ferrán Martinez-Garcia, Miguel Angel Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges |
title | Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges |
title_full | Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges |
title_fullStr | Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges |
title_full_unstemmed | Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges |
title_short | Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges |
title_sort | resistant/refractory hypertension and sleep apnoea: current knowledge and future challenges |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912579/ https://www.ncbi.nlm.nih.gov/pubmed/31694223 http://dx.doi.org/10.3390/jcm8111872 |
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