Sleep Medicine Reviews
Volume 13, Issue 5 , Pages 323-331 , October 2009

Obstructive sleep apnea/hypopnea and systemic hypertension

  • Joaquín Durán-Cantolla

      Affiliations

    • Unidad de Trastornos del Sueño, Hospital Txagorritxu, Universidad del País Vasco, C/ José Achótegui s/n, E-01009 Vitoria-Gasteiz, Álava, Spain
    • CiberRes, Ciber de Enfermedades Respiratorias (CiberRes), ISCIII
    • Corresponding Author InformationCorresponding author. Unidad de Trastornos del Sueño, Hospital Txagorritxu, C/ José Achótegui s/n, E-01009 Vitoria-Gasteiz, Álava, Spain. Tel.: +34 945 007308; fax: +34 945 007310.
    • ,
  • Felipe Aizpuru

      Affiliations

    • Unidad de Investigación de Álava, Hospital Txagorritxu, C/ José Achótegui s/n, E-01009 Vitoria-Gasteiz, Álava, Spain
    • ,
  • Cristina Martínez-Null

      Affiliations

    • Unidad de Trastornos del Sueño Hospital Txagorritxu, C/ José Achótegui s/n, E-01009 Vitoria-Gasteiz, Álava, Spain
    • CiberRes, Ciber de Enfermedades Respiratorias (CiberRes), ISCIII
    • ,
  • Ferrán Barbé-Illa

      Affiliations

    • Servicio de Neumología, Hospital Universitari Arnau de Vilanova, C/ Alcalde Rovira Roure 80, E-25198 Lleida, Spain
    • CiberRes, Ciber de Enfermedades Respiratorias (CiberRes), ISCIII

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;328:1230–1235
  2. Durán J, Esnaola S, Ramón R, Iztueta A. Obstructive sleep apnea–hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med. 2001;163:685–689
  3. Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997;20:705–706
  4. Newman AB, Nieto J, Guirdry U, Lind BK, Redline S, Sharar E, et al. Relation of sleep-disordered breathing to cardiovascular risk factors. The sleep hearth health study. Am J Epidemiol. 2001;154:50–59
  5. Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, et al. Sleep-disordered breathing and cardiovascular disease: cross sectional results of the sleep heart health study. Am J Respir Crit Care Med. 2001;163:19–25
  6. Marin JM, Carrizo SJ, Vicente E, Agustí AGN. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046–1053
  7. Parra O, Arboix A, Bechich S, García-Eroles L, Montserrat JM, López JA, et al. Time course of sleep-related breathing disorders in first-ever stroke or transient ischemic attack. Am J Respir Crit Care Med. 2000;161:375–380
  8. Terán-Santos J, Jiménez-Gómez A, Cordero-Guevara J, The Cooperative Group Burgos-Santander . . The association between sleep apnea and the risk of traffic accidents. N Engl J Med. 1999;340:847–851
  9. Lavie P, Herer P, Lavie L. Mortality risk factors in sleep apnoea: a matched case-control study. J Sleep Res. 2007;16:128–134
  10. Brooks D, Horner RL, Kozar LF, Render-Teixeira CL, Phillipson EA. Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J Clin Invest. 1997;99:106–109
  11. Stradling JR, Crosby JH. Relation between systemic hypertension and sleep hypoxaemia or snoring: analysis in 748 men drawn from general practice. BMJ. 1990;300:75–78
  12. Grunstein R, Wilcox I, Yang TS, Gould Y, Hedner J. Snoring and sleep apnoea in men: association with central obesity and hypertension. Int J Obes Relat Metab Disord. 1993;17:533–540
  13. Hoffstein V. Blood pressure, snoring, obesity, and nocturnal hypoxaemia. Lancet. 1994;344:643–645
  14. Carlson JT, Hedner JA, Ejnell H, Peterson LE. High prevalence of hypertension in sleep apnea patients independent of obesity. Am J Respir Crit Care Med. 1994;150:72–77
  15. Grunstein RR, Stenlöf K, Hedner J, Sjöström L. Impact of obstructive sleep apnea and sleepiness on metabolic and cardiovascular risk factors in the Swedish obese subjects (SOS) study. Int J Obes Relat Metab Disord. 1995;19:410–418
  16. Young T, Peppard P, Palta M, Hla KM, Finn L, Morgan B, et al. Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med. 1997;157:1746–1752
  17. Grote L, Ploch T, Heitmann J, Knaack L, Penzel T, Peter JH. Sleep-related breathing disorder is an independent risk factor for systemic hypertension. Am J Respir Crit Care Med. 1999;160:1875–1882
  18. Lavie P, Herer P, Hoffstein V. Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study. BMJ. 2000;320:479–482
  19. Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Leiby BE, Vela-Bueno A, et al. Arch Intern Med. 2000;160:2289–2295
  20. Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep heart health study. JAMA. 2000;283:1829–1836
  21. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342:1378–1384
  22. Grote L, Hedner J, Peter JH. Mean blood pressure, pulse pressure and grade of hypertension in untreated hypertensive patients with sleep-related breathing disorder. J Hypertens. 2001;19:683–690
  23. Hedner J, Bengtsson-Boström K, Peker Y, Grote L, Rastam L, Lindblad U. Hypertension prevalence in obstructive sleep apnoea and sex: a population-based case-control study. Eur Respir J. 2006;27:564–570
  24. Wilcox I, Grunstein RR, Hedner JA, Doyle J, Collins FL, Fletcher PJ, et al. Effect of nasal continuous positive airway pressure during sleep on 24-hour blood pressure in obstructive sleep apnea. Sleep. 1993;16:539–544
  25. Worsnop CJ, Pierce RJ, Naughton M. Systemic hypertension and obstructive sleep apnea. Sleep. 1993;16(8 Suppl.):S148–S149
  26. Rauscher H, Formanek D, Popp W, Zwick H. Nasal CPAP and weight loss in hypertensive patients with obstructive sleep apnoea. Thorax. 1993;48:529–533
  27. Davies RJ, Crosby J, Prothero A, Stradling JR. Ambulatory blood pressure and left ventricular hypertrophy in subjects with untreated obstructive sleep apnoea and snoring, compared with matched control subjects, and their response to treatment. Clin Sci (Lond). 1994;86:417–424
  28. Akashiba T, Kurashina K, Minemura H, Yamamoto H, Horie T. Daytime hypertension and the effects of short-term nasal continuous positive airway pressure treatment in obstructive sleep apnea syndrome. Intern Med. 1995;34:528–532
  29. Huang X, Chen M, Wu Q. Long-term effects of CPAP in obstructive apnea syndrome. Zhonghua Jie He He Hu Xi Za Zhi. 1996;19:273–275
  30. Minemura H, Akashiba T, Yamamoto H, Akahoshi T, Kosaka N, Horie T. Acute effects of nasal continuous positive airway pressure on 24-hour blood pressure and catecholamines in patients with obstructive sleep apnea. Intern Med. 1998;37:1009–1013
  31. Akashiba T, Minemura H, Yamamoto H, Kosaka N, Saito O, Horie T. Nasal continuous positive airway pressure changes blood pressure “non-dippers” to “dippers” in patients with obstructive sleep apnea. Sleep. 1999;22:849–853
  32. Hla KM, Skatrud JB, Finn L, Palta M, Young T. The effect of correction of sleep-disordered breathing on BP in untreated hypertension. Chest. 2002;122:1125–1132
  33. Tun Y, Hida W, Okabe S, Ogawa H, Kikuchi Y, Oikawa M, et al. Can nasal continuous positive airway pressure decrease clinic blood pressure in patients with obstructive sleep apnea?. Tohoku J Exp Med. 2003;201:181–190
  34. Heitmann J, Ehlenz K, Penzel T, Becker HF, Grote L, Voigt KH, et al. Sympathetic activity is reduced by nCPAP in hypertensive obstructive sleep apnoea patients. Eur Respir J. 2004;23:255–262
  35. Hermida RC, Zamarrón C, Ayala DE, Calvo C. Effect of continuous positive airway pressure on ambulatory blood pressure in patients with obstructive sleep apnoea. Blood Press Monit. 2004;9:193–202
  36. Börgel J, Sanner BM, Keskin F, Bittlinsky A, Bartels NK, Büchner N, et al. Obstructive sleep apnea and blood pressure. Interaction between the blood pressure-lowering effects of positive airway pressure therapy and antihypertensive drugs. Am J Hypertens. 2004;17:1081–1087
  37. Dhillon S, Chung SA, Fargher T, Huterer N, Shapiro CM. Sleep apnea, hypertension, and the effects of continuous positive airway pressure. Am J Hypertens. 2005;18:594–600
  38. Doherty LS, Kiely JL, Swan V, McNicholas WT. Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest. 2005;127:2076–2084
  39. Dursunoglu N, Dursunoglu D, Ozkurt S, Gur S, Ozalp G, Evyapan F. Effects of CPAP on right ventricular myocardial performance index in obstructive sleep apnea patients without hypertension. Respir Res. 2006;7:22
  40. Myslinski W, Duchna HW, Rasche K, Dichmann M, Mosiewicz J, Schultze-Werninghaus G. Left ventricular geometry in patients with obstructive sleep apnea coexisting with treated systemic hypertension. Respiration. 2007;74:176–183
  41. Martínez-García MA, Gómez-Aldaraví R, Soler-Cataluña JJ, Martínez TG, Bernácer-Alpera B, Román-Sánchez P. Positive effect of CPAP treatment on the control of difficult-to-treat hypertension. Eur Respir J. 2007;29:951–957
  42. Robinson GV, Langford BA, Smith DM, Stradling J. Predictors of blood pressure fall with continuous positive airway pressure (CPAP) treatment of obstructive sleep apnoea (OSA). Thorax. 2008;
  43. Engleman HM, Gough K, Martin SE, Kingshott RN, Padfield PL, Douglas NJ. Ambulatory blood pressure on and off continuous positive airway pressure therapy for the sleep apnea/hypopnea syndrome: effects in “non-dippers. Sleep. 1996;19:378–381
  44. Dimsdale JE, Loredo JS, Profant J. Effect of continuous positive airway pressure on blood pressure: a placebo trial. Hypertension. 2000;35:144–147
  45. Barbé F, Mayoralas LR, Duran J, Masa JF, Maimó A, Montserrat JM, et al. Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness. A randomized, controlled trial. Ann Intern Med. 2001;134:1015–1023
  46. Monasterio C, Vidal S, Duran J, Ferrer M, Carmona C, Barbé F, et al. Effectiveness of continuous positive airway pressure in mild sleep apnea–hypopnea syndrome. Am J Respir Crit Care Med. 2001;164:939–943
  47. Faccenda JF, Mackay TW, Boon NA, Douglas NJ. Randomized placebo-controlled trial of continuous positive airway pressure on blood pressure in the sleep apnea–hypopnea syndrome. Am J Respir Crit Care Med. 2001;163:344–348
  48. Barnes M, Houston D, Worsnop CJ, Neill AM, Mykytyn IJ, Kay A, et al. A randomized controlled trial of continuous positive airway pressure in mild obstructive sleep apnea. Am J Respir Crit Care Med. 2002;165:773–780
  49. Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet. 2002;359:204–210
  50. Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation. 2003;107:68–73
  51. Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, et al. Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med. 2003;348:1233–1241
  52. Barnes M, McEvoy RD, Banks S, Tarquinio N, Murray CG, Vowles N, et al. Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med. 2004;170:656–664
  53. Ip MS, Tse HF, Lam B, Tsang KWT, Lam WK. Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med. 2004;169:348–353
  54. Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT. Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure. Am J Respir Crit Care Med. 2004;169:361–366
  55. Arias MA, García-Río F, Alonso-Fernández A, Mediano O, Martínez I, Villamor J. Obstructive sleep apnea syndrome affects left ventricular diastolic function: effects of nasal continuous positive airway pressure in men. Circulation. 2005;112:375–383
  56. Usui K, Bradley TD, Spaak J, Ryan CM, Kubo T, Kaneko Y, et al. Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure. J Am Coll Cardiol. 2005;45:2008–2011
  57. Campos-Rodriguez F, Grilo-Reina A, Perez-Ronchel J, Merino-Sanchez M, Gonzalez-Benitez MA, Beltran-Robles M, et al. Effect of continuous positive airway pressure on ambulatory BP in patients with sleep apnea and hypertension: a placebo-controlled trial. Chest. 2006;129:1459–1467
  58. Arias MA, García-Río F, Alonso-Fernández A, Martínez I, Villamor J. Pulmonary hypertension in obstructive sleep apnoea: effects of continuous positive airway pressure: a randomized, controlled cross-over study. Eur Heart J. 2006;27:1106–1113
  59. Mills PJ, Kennedy BP, Loredo JS, Dimsdale JE, Ziegler MG. Effects of nasal continuous positive airway pressure and oxygen supplementation on norepinephrine kinetics and cardiovascular responses in obstructive sleep apnea. J Appl Physiol. 2006;100:343–348
  60. Robinson GV, Smith DM, Langford BA, Davies RJ, Stradling JR. Continuous positive airway pressure does not reduce blood pressure in nonsleepy hypertensive OSA patients. Eur Respir J. 2006;27:1229–1235
  61. Hui DS, To KW, Ko FW, Fok JP, Chan MC, Ngai JC, et al. Nasal CPAP reduces systemic blood pressure in patients with obstructive sleep apnoea and mild sleepiness. Thorax. 2006;61:1083–1090
  62. Norman D, Loredo JS, Nelesen RA, Ancoli-Israel S, Mills PJ, Ziegler MG, et al. Effects of continuous positive airway pressure versus supplemental oxygen on 24-hour ambulatory blood pressure. Hypertension. 2006;47:840–845
  63. Kohler M, Peperrel JCT, Casadei B, Craig S, Crosthwaite N, Stradling J, et al. Continuous positive airway pressure and measures of cardiovascular risk in men with OSAS. Eur Respir J. 2008;
  64. Giles TL, Lasserson TJ, Smith BJ, White J, Wright J, Cates CJ. Continuous positive airways pressure for obstructive sleep apnea in adults. Cochrane Database Syst Rev. 2006;1:CD001106
  65. Alajmi M, Mulgrew AT, Fox J, Davidson W, Schulzer M, Mak E, et al. Impact of continuous positive airway pressure therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung. 2007;185:62–72
  66. Haentjens P, Van Meerhaeghe A, Mascariello A, Weerdt De, Poppe C, Dupont A, et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome. Arch Intern Med. 2007;167:757–765
  67. Mo L, He Q. Effect of long-term continuous positive airway pressure ventilation on blood pressure in patients with obstructive sleep apnea hypopnea syndrome: a meta-analysis of clinical trials. Zhonghua Yi Xue Za Zhi. 2007;87:1177–1180
  68. Bazzano LA, Khan Z, Reynolds K, He J. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension. 2007;50:417–423
  69. Barnett AG, van der Pols JC, Dobson AJ. Regression to the mean: what it is and how to deal with it. Int J Epidemiol. 2005;34:215–220
  70. Logan AG, Tkacova R, Perlikowski SM, Leung RS, Tisler A, Floras JS, et al. Refractory hypertension and sleep apnoea: effect of CPAP on blood pressure and baroreflex. Eur Respir J. 2003;21:241–247
  71. Gotsopoulos H, Kelly JJ, Cistulli PA. Oral appliance therapy reduces blood pressure in obstructive sleep apnea: a randomized, controlled trial. Sleep. 2004;27:934–941
  72. Otsuka R, Ribeiro de Almeida F, Lowe AA, Linden W, Ryan F. The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea. Sleep Breath. 2006;10:29–36
  73. Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362:1527–1535
  74. Peker Y, Hedner J, Norum J, Kraiczi H, Carlson J. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up. Am J Respir Crit Care Med. 2002;166:159–165

PII: S1087-0792(08)00126-3

doi: 10.1016/j.smrv.2008.11.001

Sleep Medicine Reviews
Volume 13, Issue 5 , Pages 323-331 , October 2009

Article Tools

* Image Usage & Resolution