Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges

Hypertension is one of the most frequent cardiovascular risk factors. The population of hypertensive patients includes some phenotypes whose blood pressure levels are particularly difficult to control, thus putting them at greater cardiovascular risk. This is especially true of so-called resistant h...

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Autores: Oscullo, Grace, Torres, Gerard, Campos-Rodríguez, Francisco, Posadas, Tomás, Reina-González, Angela, Sapiña Beltrán, Esther, Barbé Illa, Ferran, Martínez-García, Miguel Angel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Universitat de Lleida (UdL)
Repositorio:Repositori Obert UdL
OAI Identifier:oai:repositori.udl.cat:10459.1/68838
Acceso en línea:https://doi.org/10.3390/jcm8111872
http://hdl.handle.net/10459.1/68838
Access Level:acceso abierto
Palabra clave:Resistant hypertension
Refractory hypertension
Obstructive sleep apnoea
Continuous positive airway pressure
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spelling Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future ChallengesOscullo, GraceTorres, GerardCampos-Rodríguez, FranciscoPosadas, TomásReina-González, AngelaSapiña Beltrán, EstherBarbé Illa, FerranMartínez-García, Miguel AngelResistant hypertensionRefractory hypertensionObstructive sleep apnoeaContinuous positive airway pressureHypertension is one of the most frequent cardiovascular risk factors. The population of hypertensive patients includes some phenotypes whose blood pressure levels are particularly difficult to control, thus putting them at greater cardiovascular risk. This is especially true of so-called resistant hypertension (RH) and refractory hypertension (RfH). Recent findings suggest that the former may be due to an alteration in the renin–angiotensin–aldosterone axis, while the latter seems to be more closely related to sympathetic hyper-activation. Both these pathophysiological mechanisms are also activated in patients with obstructive sleep apnoea (OSA). It is not surprising, therefore, that the prevalence of OSA in RH and RfH patients is very high (as reflected in several studies) and that treatment with continuous positive airway pressure (CPAP) manages to reduce blood pressure levels in a clinically significant way in both these groups of hypertensive patients. It is therefore necessary to incorporate into the multidimensional treatment of patients with RH and RfH (changes in lifestyle, control of obesity and drug treatment) a study of the possible existence of OSA, as this is a potentially treatable disease. There are many questions that remain to be answered, especially regarding the ideal combination of treatment in patients with RH/RfH and OSA (drugs, renal denervation, CPAP treatment) and patients’ varying response to CPAP treatment.MDPI2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://doi.org/10.3390/jcm8111872http://hdl.handle.net/10459.1/68838reponame:Repositori Obert UdL instname:Universitat de Lleida (UdL)InglésReproducció del document publicat a https://doi.org/10.3390/jcm8111872Journal of Clinical Medicine, 2019, vol. 8, núm. 11, p. 1872cc-by, (c) Oscullo et al., 2019info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/4.0/oai:repositori.udl.cat:10459.1/688382026-06-24T12:42:17Z
dc.title.none.fl_str_mv Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges
title Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges
spellingShingle Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges
Oscullo, Grace
Resistant hypertension
Refractory hypertension
Obstructive sleep apnoea
Continuous positive airway pressure
title_short Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges
title_full Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges
title_fullStr Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges
title_full_unstemmed Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges
title_sort Resistant/Refractory Hypertension and Sleep Apnoea: Current Knowledge and Future Challenges
dc.creator.none.fl_str_mv Oscullo, Grace
Torres, Gerard
Campos-Rodríguez, Francisco
Posadas, Tomás
Reina-González, Angela
Sapiña Beltrán, Esther
Barbé Illa, Ferran
Martínez-García, Miguel Angel
author Oscullo, Grace
author_facet Oscullo, Grace
Torres, Gerard
Campos-Rodríguez, Francisco
Posadas, Tomás
Reina-González, Angela
Sapiña Beltrán, Esther
Barbé Illa, Ferran
Martínez-García, Miguel Angel
author_role author
author2 Torres, Gerard
Campos-Rodríguez, Francisco
Posadas, Tomás
Reina-González, Angela
Sapiña Beltrán, Esther
Barbé Illa, Ferran
Martínez-García, Miguel Angel
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Resistant hypertension
Refractory hypertension
Obstructive sleep apnoea
Continuous positive airway pressure
topic Resistant hypertension
Refractory hypertension
Obstructive sleep apnoea
Continuous positive airway pressure
description Hypertension is one of the most frequent cardiovascular risk factors. The population of hypertensive patients includes some phenotypes whose blood pressure levels are particularly difficult to control, thus putting them at greater cardiovascular risk. This is especially true of so-called resistant hypertension (RH) and refractory hypertension (RfH). Recent findings suggest that the former may be due to an alteration in the renin–angiotensin–aldosterone axis, while the latter seems to be more closely related to sympathetic hyper-activation. Both these pathophysiological mechanisms are also activated in patients with obstructive sleep apnoea (OSA). It is not surprising, therefore, that the prevalence of OSA in RH and RfH patients is very high (as reflected in several studies) and that treatment with continuous positive airway pressure (CPAP) manages to reduce blood pressure levels in a clinically significant way in both these groups of hypertensive patients. It is therefore necessary to incorporate into the multidimensional treatment of patients with RH and RfH (changes in lifestyle, control of obesity and drug treatment) a study of the possible existence of OSA, as this is a potentially treatable disease. There are many questions that remain to be answered, especially regarding the ideal combination of treatment in patients with RH/RfH and OSA (drugs, renal denervation, CPAP treatment) and patients’ varying response to CPAP treatment.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://doi.org/10.3390/jcm8111872
http://hdl.handle.net/10459.1/68838
url https://doi.org/10.3390/jcm8111872
http://hdl.handle.net/10459.1/68838
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a https://doi.org/10.3390/jcm8111872
Journal of Clinical Medicine, 2019, vol. 8, núm. 11, p. 1872
dc.rights.none.fl_str_mv cc-by, (c) Oscullo et al., 2019
info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by/4.0/
rights_invalid_str_mv cc-by, (c) Oscullo et al., 2019
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Repositori Obert UdL
instname:Universitat de Lleida (UdL)
instname_str Universitat de Lleida (UdL)
reponame_str Repositori Obert UdL
collection Repositori Obert UdL
repository.name.fl_str_mv
repository.mail.fl_str_mv
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