OSA is an independent risk factor for hypertension; studies have shown that patients with Obstructive Sleep Apnoea have significantly higher blood pressure than matched controls. This causal relationship is thought to be due to the sympathetic response to intermittent hypoxemia, negative intrathoracic pressures and arousals from sleep. Research shows a reversal of resistant hypertension by effective treatment of OSA in some patients. This publication give recommendations for the management of patients with OSA and hypertension.
There are a large number of risk factors that overlap for sleep disordered breathing and hypertension (for example obesity and increasing age). If a patient with hypertension is not responding to anti-hypertensive medications, they should be assessed for a sleep breathing disorder. It is common to see resolution of the hypertension with effective treatment for OSA. Below, David discusses the development or exacerbation of hypertension in patients with OSA.