| Antihypertensive therapy for patients with obstructive sleep apnea. | |
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MedLine Citation:
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PMID: 21326007 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Patients with obstructive sleep apnea (OSA) often have hypertension that is difficult to control. We review the causes of OSA hypertension and evidence supporting specific therapies. RECENT FINDINGS: Sleep apnea commonly accompanies the metabolic syndrome and renal insuffiency. Apneas stimulate atrial natriuretic peptide release and sympathetic nerve activity, which persists throughout the daytime. The combination of increased sympathetic nerve activity and a nocturnal diuresis help explain reports that β-1 antagonists lower blood pressure more than thiazide diuretics in OSA. The angiotensin-converting enzyme (ACE) inhibitors and angiotensin II blocking drugs have been equally effective in some studies. Patients with treatment-resistant hypertension usually have OSA and have had a good antihypertensive response to spironolactone. SUMMARY: Although most elderly hypertensives respond to diuretics and calcium channel blockers, patients with OSA responded to β-1 adrenergic blockers, ACE inhibitors, and angiotensin II blocking drugs. The response to a second drug is not known. However, many patients with OSA remain hypertensive on three antihypertensive agents, in which case the addition of spironolactone has been effective. It is reasonable to prescribe shorter acting antihypertensive drugs at night to treat nocturnal hypertension. |
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Authors:
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Michael G Ziegler; Milos Milic; Ping Sun |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Current opinion in nephrology and hypertension Volume: 20 ISSN: 1535-3842 ISO Abbreviation: Curr. Opin. Nephrol. Hypertens. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-02-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9303753 Medline TA: Curr Opin Nephrol Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 50-5 Citation Subset: IM |
Affiliation:
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University of California San Diego, San Diego, California, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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