Sleep Disorder Centre, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Via Magnasco, 2, Milan, Italy.
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Curr Hypertens Rep. 2019 Apr 4;21(4):30. doi: 10.1007/s11906-019-0935-x.
Obstructive sleep apnea (OSA) and hypertension are two phenomena deeply linked together and, although a causal relationship has been suggested, a recent meta-analysis showed only a very modest effect of OSA treatment on blood pressure (BP). However, a vast number of randomized controlled trials published so far share some limitations, mainly of methodological nature: neither OSA nor BP is always assessed in a standardized way. Moreover, compliance with OSA treatment is often sub-optimal making the results of these trials difficult to interpret.
Recent studies have shown that antihypertensive drugs can reduce BP more than OSA treatment, showing a better compliance profile and very few side effects. Considering the importance of reducing the overall cardiovascular risk of OSA patients, a more careful management of patient's antihypertensive medication could allow a better BP control also in this condition. In addition, greater efforts should be made to improve patient's acceptance of OSA treatment with the aim of improving their compliance.
阻塞性睡眠呼吸暂停（OSA）和高血压是两种密切相关的现象，尽管已经提出了因果关系，但最近的荟萃分析显示，OSA 治疗对血压（BP）的影响非常有限。然而，迄今为止发表的大量随机对照试验存在一些局限性，主要是方法学性质：OSA 或 BP 并非总是以标准化的方式进行评估。此外，OSA 治疗的依从性往往不理想，使得这些试验的结果难以解释。
最近的研究表明，降压药物可以比 OSA 治疗更有效地降低血压，具有更好的顺应性和很少的副作用。考虑到降低 OSA 患者整体心血管风险的重要性，更仔细地管理患者的降压药物可能会使血压在这种情况下得到更好的控制。此外，应做出更大的努力来提高患者对 OSA 治疗的接受程度，以提高他们的依从性。
