First Cardiology Clinic, University of Athens, Hippokration Hospital, Greece.
J Hypertens. 2010 May;28(5):875-82. doi: 10.1097/HJH.0b013e328336ed85.
Hypertension is highly prevalent and usually uncontrolled among patients with obstructive sleep apnea despite multiple interventions, namely lifestyle modifications, use of antihypertensive drugs and continuous positive airway pressure application. Main prognosticators of the blood pressure (BP) reduction with continuous positive airway pressure therapy are high levels of BP, severity of apnea and daytime sleepiness. The long-term effect of continuous positive airway pressure on BP is still inconclusive, and compliance issues constitute a major limitation. There is no clear evidence for preference for a specific type of antihypertensive drug, and selection should primarily be guided by the patient's cardiometabolic profile and associated clinical conditions. Furthermore, as hypertensive patients with obstructive sleep apnea frequently exhibit a disturbed circadian BP pattern, chronotherapy emerges as a possible therapeutic supplement.
尽管进行了多种干预，包括生活方式改变、使用降压药物和持续气道正压通气（CPAP）应用，阻塞性睡眠呼吸暂停患者的高血压仍然非常普遍且通常无法得到控制。CPAP 治疗降低血压的主要预测因素是血压水平高、呼吸暂停严重程度和白天嗜睡。CPAP 对血压的长期影响仍不确定，依从性问题是一个主要限制。对于特定类型的降压药物没有明确的偏好证据，选择应主要根据患者的心脏代谢特征和相关临床情况来指导。此外，由于患有阻塞性睡眠呼吸暂停的高血压患者经常表现出昼夜节律血压模式紊乱，因此时间治疗学可能成为一种潜在的治疗补充。
