Resistant Hypertension? New Article in Hypertension Identifies Sleep Apnea As The Most Common Secondary Cause Of Resistant Hypertension

Treatment of Sleep Apnea is extremely important with hypertension. Effective treatment with oral appliances or CPAP is extremely important in patients with resistant hypertension. The abstract can be found below.

Treatment of Sleep Apnea is essential. If you or your loved one are one of the 60% of patients who do not tolerate CPAP call today to schedule an appointment for a comfortable oral appliance.



Hypertension. 2011 Nov;58(5):811-7. Epub 2011 Oct 3.
Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension.
Pedrosa RP, Drager LF, Gonzaga CC, Sousa MG, de Paula LK, Amaro AC, Amodeo C, Bortolotto LA, Krieger EM, Bradley TD, Lorenzi-Filho G.
Source
Sleep Laboratory, Pulmonary Division, Heart Institute, Av Enéas Carvalho de Aguiar 44, São Paulo, Brazil. geraldo.lorenzi@incor.usp.br.
Abstract
Recognition and treatment of secondary causes of hypertension among patients with resistant hypertension may help to control blood pressure and reduce cardiovascular risk. However, there are no studies systematically evaluating secondary causes of hypertension according to the Seventh Joint National Committee. Consecutive patients with resistant hypertension were investigated for known causes of hypertension irrespective of symptoms and signs, including aortic coarctation, Cushing syndrome, obstructive sleep apnea, drugs, pheochromocytoma, primary aldosteronism, renal parenchymal disease, renovascular hypertension, and thyroid disorders. Among 125 patients (age: 52±1 years, 43% males, systolic and diastolic blood pressure: 176±31 and 107±19 mm Hg, respectively), obstructive sleep apnea (apnea-hypopnea index: >15 events per hour) was the most common condition associated with resistant hypertension (64.0%), followed by primary aldosteronism (5.6%), renal artery stenosis (2.4%), renal parenchymal disease (1.6%), oral contraceptives (1.6%), and thyroid disorders (0.8%). In 34.4%, no secondary cause of hypertension was identified (primary hypertension). Two concomitant secondary causes of hypertension were found in 6.4% of patients. Age >50 years (odds ratio: 5.2 [95% CI: 1.9-14.2]; P<0.01), neck circumference ≥41 cm for women and ≥43 cm for men (odds ratio: 4.7 [95% CI: 1.3-16.9]; P=0.02), and presence of snoring (odds ratio: 3.7 [95% CI: 1.3-11]; P=0.02) were predictors of obstructive sleep apnea. In conclusion, obstructive sleep apnea appears to be the most common condition associated with resistant hypertension. Age >50 years, large neck circumference measurement, and snoring are good predictors of obstructive sleep apnea in this populati
Can J Cardiol. 2011 May-Jun;27(3):319-38.