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Neurogenic mechanisms linking sleep apnea and hypertension have gathered attention due to their immediate bedside utility, with emerging pathogenic discoveries and novel management strategies.
This review highlights the neurogenic mechanisms linking sleep apnea to hypertension and discusses emerging therapies like upper airway stimulation and renal denervation.
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Alerts clinicians to screen for sleep apnea in neurogenic hypertension; extends mechanistic insights but leaves comparative efficacy of novel therapies unresolved.
Sleep apnea is very common in patients with cardiovascular disease, especially in patients with hypertension. Over the last few decades a number of discoveries have helped support a causal relationship between the two and even resistant hypertension. The role neurogenic mechanisms play has gathered more attention in the recent past due to their immediate bedside utility. Several innovative discoveries in pathogenesis including those exploring the role of baroreflex gain, cardiovascular variability, chemoreceptor reflex activation and the sympathetic nervous system have emerged. In this review, we discuss the epidemiology of sleep apnea and hypertension and the pathogenic mechanisms contributing to neurogenic hypertension. Furthermore, recent management strategies in addition to continuous positive airway pressure (CPAP), such as upper airway stimulation and renal denervation that target these pathogenic mechanisms, are also discussed.
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Venkataraman et al. (2020) studied this question.
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