Severity of sleep apnea impacts risk of resistant high blood pressure

August 14, 2014

A new study shows a strong association between severe, untreated obstructive sleep apnea and the risk of elevated blood pressure despite the use of high blood pressure medications.

The study involved patients who had or established and moderate or severe obstructive . Among participants prescribed at least three antihypertensives including a diuretic, resistant elevated was more prevalent in those with severe sleep apnea (58.3 %) compared with moderate sleep apnea (28.6%). Further analysis found that the odds of resistant elevated blood pressure were four times higher in participants with severe, untreated obstructive sleep apnea even after adjusting for potential confounders such as body mass index, smoking status, diabetes mellitus, and cardiovascular disease (adjusted odds ratio = 4.12).

"Our findings suggest that severe obstructive sleep apnea contributes to poor blood pressure control despite aggressive medication use," said first author Dr. Harneet Walia, assistant professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. "This is an important finding from a clinical perspective as poor blood pressure control in patients taking multiple antihypertensive medications makes them particularly vulnerable to increased cardiovascular risk."

Study results are published in the Aug. 15 issue of the Journal of Clinical Sleep Medicine, which is published by the American Academy of Sleep Medicine.

"High blood pressure that is resistant to treatment with medications is a strong warning sign for the presence of obstructive sleep apnea, a chronic disease that increases the risk for heart disease and stroke," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler. "Over one-third of patients with hypertension and nearly eight out of 10 patients with treatment resistant hypertension have obstructive sleep apnea. People who have high blood pressure should talk to a doctor about their risk for sleep apnea."

Data were analyzed from the baseline examination of the Heart Biomarker Evaluation in Apnea Treatment (HeartBEAT) study, a four-site randomized controlled trial comprising patients with moderate to severe OSA who were under cardiovascular disease management. The analysis involved 284 participants, of which 73 were prescribed an intensive antihypertensive regimen.

"Even under the close care of a cardiologist following national guidelines for treatment of cardiovascular risk and comprehensive medication regimens, severe levels of obstructive sleep apnea versus a moderate level of OSA appear to be contributing to suboptimal blood pressure control," said Walia.

According to the Centers for Disease Control and Prevention, about 36 million American adults with high blood pressure don't have it under control. The American Academy of Sleep Medicine reports that approximately 80 percent of people with drug-resistant have , which involves repetitive episodes of complete or partial upper airway obstruction occurring during sleep despite an ongoing effort to breathe.

Explore further: CPAP superior to supplemental oxygen for BP reduction in obstructive sleep apnea

More information: "Association of Severe Obstructive Sleep Apnea and Elevated Blood Pressure Despite Antihypertensive Medication Use," Journal of Clinical Sleep Medicine, 2014.

"Resistant Hypertension and Untreated Severe Sleep Apnea: Slowly Gaining Insight," Journal of Clinical Sleep Medicine, 2014.

Related Stories

CPAP superior to supplemental oxygen for BP reduction in obstructive sleep apnea

June 11, 2014
Continuous positive airway pressure (CPAP), the most widely prescribed therapy for treatment of obstructive sleep apnea, resulted in significantly lower blood pressure compared to either nocturnal supplemental oxygen or an ...

Study links severe sleep apnea to increased risk of stroke, cancer and death

April 14, 2014
A new study shows that moderate to severe obstructive sleep apnea is independently associated with an increased risk of stroke, cancer and death.

No apparent link between sleep apnea and cancer

August 5, 2014
Obstructive sleep apnea, in which people stop breathing for short periods while sleeping, affects about 5% of Canadian adults aged 45 years or older and can negatively affect health. More than 1 in 5 adult Canadians have ...

Patients with type 2 diabetes or hypertension must be evaluated for sleep apnea

June 3, 2013
The American Academy of Sleep Medicine (AASM) is advising anyone with Type 2 diabetes or hypertension to be evaluated for sleep apnea by a board-certified sleep medicine physician. The recommendation comes as the group of ...

Treatment of obstructive sleep apnea improves blood pressure in men

October 13, 2012
A new study suggests that when prescribed by physicians in routine practice and used appropriately by patients, treatment for obstructive sleep apnea (OSA) could reduce blood pressure in men with hypertension.

Study links obstructive sleep apnea to blood vessel abnormalities

July 11, 2011
Obstructive sleep apnea may cause changes in blood vessel function that reduces blood supply to the heart in people who are otherwise healthy, according to new research reported in Hypertension: Journal of the American Heart ...

Recommended for you

Anti-nausea drug could help treat sleep apnea

June 6, 2017
An old pharmaceutical product may be a new treatment for obstructive sleep apnea, according to new research presented today by University of Illinois at Chicago and Northwestern University scientists at the SLEEP 2017 annual ...

New disposable, wearable patch found to effectively detect sleep apnea

June 4, 2017
Results of a definitive clinical trial show that a new, disposable diagnostic patch effectively detects obstructive sleep apnea across all severity levels.

Childhood sleep apnoea is common but hard to diagnose

April 28, 2017
The cessation of breathing during sleep caused by enlarged tonsils is common in preschool-age children and can cause serious complications, but the methods normally used to diagnose the condition are subjective and unreliable. ...

Curbing sleep apnea might mean fewer night trips to bathroom

March 27, 2017
(HealthDay)—Millions of Americans battle bothersome nighttime conditions, such as sleep apnea or the need to get up frequently to urinate.

Untreated sleep apnea in children can harm brain cells tied to cognition and mood

March 17, 2017
A study comparing children between 7 and 11 years of age who have moderate or severe obstructive sleep apnea to children the same age who slept normally, found significant reductions of gray matter - brain cells involved ...

Dietary supplement derived from tree bark shows promise for treating obstructive sleep apnea

February 24, 2017
Obstructive sleep apnea, which causes people to briefly stop breathing while asleep, affects an estimated 5 percent of the population, not including the many more who don't even realize they suffer from the disorder.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.