Why the study?
Target blood pressure is achieved in less than 50% of arterial hypertension cases, and uncontrolled hypertension frequently co-occurs with obstructive sleep apnea through shared pathophysiological mechanisms.
Does continuous positive airway pressure (PAP-therapy) reduce blood pressure in patients with uncontrolled arterial hypertension and obstructive sleep apnea?
Does continuous positive airway pressure (PAP-therapy) reduce blood pressure in patients with uncontrolled arterial hypertension and obstructive sleep apnea?
PAP-therapy is highlighted as an effective adjunctive treatment for achieving target blood pressure in patients with uncontrolled hypertension and comorbid obstructive sleep apnea.
The main goal in the arterial hypertension (AH) management is the target blood pressure (BP) achievement, as it leads to the cardiovascular risk reduction. At the same time, proper BP is achieved less than in 50% of all cases. In addition, there are two types of truly uncontrolled AH in population, such as resistant (RAH) and refractory (RFH) AH. Recent research suggests that RAH may be associated with changes in the renin-angiotensin-aldosterone system, while RFH appears to be more closely associated with sympathetic hyperactivation. These pathophysiological mechanisms are also active in patients with obstructive sleep apnea (OSA). Therefore, the prevalence of OSA in patients with RAH and RFH is very high, and treatment with continuous positive airway pressure (PAP-therapy) can reduce BP levels in such patients. The latter allows us to consider PAP-therapy as an additional method for the target BP achievement in patients with uncontrolled AH and OSA.
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Mikhailova et al. (2022) studied this question.
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