Document Detail


Intermittent hypoxia: cause of or therapy for systemic hypertension?
MedLine Citation:
PMID:  18408145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
During acute episodes of hypoxia, chemoreceptor-mediated sympathetic activity increases heart rate, cardiac output, peripheral resistance and systemic arterial pressure. However, different intermittent hypoxia paradigms produce remarkably divergent effects on systemic arterial pressure in the post-hypoxic steady state. The hypertensive effects of obstructive sleep apnea (OSA) vs. the depressor effects of therapeutic hypoxia exemplify this divergence. OSA, a condition afflicting 15-25% of American men and 5-10% of women, has been implicated in the pathogenesis of systemic hypertension and is a major risk factor for heart disease and stroke. OSA imposes a series of brief, intense episodes of hypoxia and hypercapnia, leading to persistent, maladaptive chemoreflex-mediated activation of the sympathetic nervous system which culminates in hypertension. Conversely, extensive evidence in animals and humans has shown controlled intermittent hypoxia conditioning programs to be safe, efficacious modalities for prevention and treatment of hypertension. This article reviews the pertinent literature in an attempt to reconcile the divergent effects of intermittent hypoxia therapy and obstructive sleep apnea on hypertension. Special emphasis is placed on research conducted in the nations of the former Soviet Union, where intermittent hypoxia conditioning programs are being applied therapeutically to treat hypertension in patients. Also reviewed is evidence regarding mechanisms of the pro- and anti-hypertensive effects of intermittent hypoxia.
Authors:
Tatiana V Serebrovskaya; Eugenia B Manukhina; Michael L Smith; H Fred Downey; Robert T Mallet
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2008-04-11
Journal Detail:
Title:  Experimental biology and medicine (Maywood, N.J.)     Volume:  233     ISSN:  1535-3702     ISO Abbreviation:  Exp. Biol. Med. (Maywood)     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-26     Completed Date:  2008-07-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100973463     Medline TA:  Exp Biol Med (Maywood)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  627-50     Citation Subset:  IM    
Affiliation:
Bogomoletz Institute of Physiology, 4 Bogomoletz St., Kiev 01024, Ukraine. sereb@biph.kiev.ua
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MeSH Terms
Descriptor/Qualifier:
Altitude
Animals
Anoxia*
Blood Pressure
Climate
Equipment Design
Female
Hemodynamics
Humans
Hypertension* / therapy
Male
Models, Biological
Nervous System
Reactive Oxygen Species
Sleep Apnea, Obstructive / pathology
Grant Support
ID/Acronym/Agency:
AT-003598/AT/NCCAM NIH HHS
Chemical
Reg. No./Substance:
0/Reactive Oxygen Species

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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