Journal
JOURNAL OF HYPERTENSION
Volume 28, Issue 5, Pages 875-882Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HJH.0b013e328336ed85
Keywords
chronotherapy; circadian rhythm; continuous positive airway pressure; hypertension; sleep apnea
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Hypertension is highly prevalent and usually uncontrolled among patients with obstructive sleep apnea despite multiple interventions, namely lifestyle modifications, use of antihypertensive drugs and continuous positive airway pressure application. Main prognosticators of the blood pressure (BP) reduction with continuous positive airway pressure therapy are high levels of BP, severity of apnea and daytime sleepiness. The long-term effect of continuous positive airway pressure on BP is still inconclusive, and compliance issues constitute a major limitation. There is no clear evidence for preference for a specific type of antihypertensive drug, and selection should primarily be guided by the patient's cardiometabolic profile and associated clinical conditions. Furthermore, as hypertensive patients with obstructive sleep apnea frequently exhibit a disturbed circadian BP pattern, chronotherapy emerges as a possible therapeutic supplement. J Hypertens 28:875-882 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
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