Vascular Biology and Hypertension Program, Sleep/Wake Disorders Center, University of Alabama at Birmingham, 430 BMR2, 1530 3rd Avenue South, Birmingham, AL 35294-2180, USA.
Curr Hypertens Rep. 2010 Jun;12(3):189-95. doi: 10.1007/s11906-010-0112-8.
Obstructive sleep apnea (OSA) and hypertension commonly coexist. Observational studies indicate that untreated OSA is associated with an increased risk of prevalent hypertension, whereas prospective studies of normotensive cohorts suggest that OSA may increase the risk of incident hypertension. Randomized evaluations of continuous positive airway pressure (CPAP) indicate an overall modest effect on blood pressure. However, these studies do indicate a wide variation in the blood pressure effects of CPAP, with some patients, on an individual basis, manifesting a large antihypertensive benefit. OSA is particularly common in patients with resistant hypertension. The reason for this high prevalence of OSA is not fully explained, but data from our laboratory suggest that it may be related to the high occurrence of hyperaldosteronism in patients with resistant hypertension. We hypothesize that aldosterone excess worsens OSA by promoting accumulation of fluid in the neck, which then contributes to increased upper airway resistance.
阻塞性睡眠呼吸暂停（OSA）和高血压通常并存。观察性研究表明，未经治疗的 OSA 与高血压患病率增加相关，而对血压正常队列的前瞻性研究表明，OSA 可能增加高血压发生的风险。对持续气道正压通气（CPAP）的随机评估表明，其对血压的总体影响较小。然而，这些研究确实表明 CPAP 的血压效应存在广泛的差异，一些患者在个体基础上表现出较大的降压益处。阻塞性睡眠呼吸暂停在难治性高血压患者中尤为常见。OSA 如此高发的原因尚未完全阐明，但我们实验室的数据表明，这可能与难治性高血压患者中醛固酮增多症的高发生率有关。我们假设，醛固酮过多通过促进颈部液体堆积而加重 OSA，进而导致上呼吸道阻力增加。
