Characteristics of hypertension in obstructive sleep apnea: An Asian experience
Journal
Journal of clinical hypertension (Greenwich, Conn.)
Journal Volume
23
Journal Issue
3
Pages
489
Date Issued
2021-03
Author(s)
Hoshide, Satoshi
Kario, Kazuomi
Chia, Yook-Chin
Siddique, Saulat
Buranakitjaroen, Peera
Tsoi, Kelvin
Tay, Jam Chin
Turana, Yuda
Chen, Chen-Huan
Cheng, Hao-Min
Huynh, Van Minh
Park, Sungha
Soenarta, Arieska Ann
Sogunuru, Guru Prasad
Wang, Ji-Guang
Abstract
Obstructive sleep apnea (OSA) is a risk of hypertension and is associated with cardiovascular disease (CVD) incidence. In Asian countries, the prevalence of OSA is high, as in Western countries. When blood pressure (BP) is evaluated in OSA individuals using ambulatory BP monitoring (ABPM), the BP phenotype often indicates abnormal BP variability, such as increased nighttime BP or abnormal diurnal BP variation, that is, non-dipper pattern, riser pattern, and morning BP surge, and all these conditions have been associated with increased CVD events. Asians have a higher prevalence of increased nighttime BP or morning BP surge than Westerners. Therefore, this review paper focused on OSA and hypertension from an Asian perspective to investigate the importance of the association between OSA and hypertension in the Asian population. Such abnormal BP variability has been shown to be associated with progression of arterial stiffness, and this association could provoke a vicious cycle between abnormal BP phenotypes and arterial stiffness, a phenomenon recognized as systemic hemodynamic atherothrombotic syndrome (SHATS). OSA may be one of the background factors that augment SHATS. An oxygen-triggered nocturnal oscillometric BP measurement device combined with a pulse oximeter for continuous SpO2 monitoring could detect BP variability caused by OSA. In addition to treating the OSA, accurate and reliable detection and treatment of any residual BP elevation and BP variability caused by OSA would be necessary to prevent CVD events. However, more detailed detection of BP variability, such as beat-by-beat BP monitoring, would further help to reduce CV events.
Subjects
blood pressure variability; hypertension; obstructive sleep apnea
SDGs
Other Subjects
amlodipine; antihypertensive agent; atenolol; enalapril; hydrochlorothiazide; losartan; aerobic exercise; antihypertensive therapy; apnea hypopnea index; Asia; Asian; blood pressure; body mass; continuous positive airway pressure; follow up; human; hypertension; kidney denervation; lifestyle modification; obesity; polysomnography; primary hyperaldosteronism; Review; sleep disordered breathing; Asian continental ancestry group; blood pressure monitoring; hypertension; sleep disordered breathing; Asia; Asian Continental Ancestry Group; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Humans; Hypertension; Sleep Apnea, Obstructive
Publisher
WILEY
Type
review