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Review Series - Recent Advances in the Management of Secondary Hypertension

Recent advances in the management of secondary hypertension—obstructive sleep apnea

Abstract

Since obstructive sleep apnea (OSA) is known as a common cause of secondary hypertension, it is necessary to consider OSA a differential diagnosis in treating patients with hypertension. Apnea during sleep causes temporary and repeated hypoxia and subsequent sympathetic nerve activation. Furthermore, dysfunction of endothelial cells due to hypoxia is considered another mechanism leading to enhanced stiffness of the elastic artery and eventually, elevation of blood pressure (BP). As a result, OSA induces a nighttime or morning surge in BP, and long-standing severe OSA also causes daytime hypertension. Therefore, treatment of OSA may be important for BP control, especially in severe OSA cases. For the treatment of OSA, continuous positive airway pressure (CPAP) is a major treatment option, though alternative devices may be useful in CPAP-intolerant cases.

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Correspondence to Tomotake Tokunou.

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SA is supported by Teijin Pharma Co., Ltd, and Philips as research funding. TT has no conflict of interest.

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Tokunou, T., Ando, Si. Recent advances in the management of secondary hypertension—obstructive sleep apnea. Hypertens Res 43, 1338–1343 (2020). https://doi.org/10.1038/s41440-020-0494-1

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  • DOI: https://doi.org/10.1038/s41440-020-0494-1

Keywords

  • Obstructive sleep apnea
  • Secondary hypertension
  • Resistant hypertension
  • Continuous positive airway pressure

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