Sleep and Resistant Hypertension

• Type of Material: Article
• Authors: Mercedes R. Carnethon, Northwestern University; Dayna Johnson, Emory University
• Language: English
• Date: 2019-05-01
• Publisher: Springer
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © Springer Science+Business Media, LLC, part of Springer Nature 2019.
• Final Published Version (URL): http://dx.doi.org/10.1007/s11906-019-0941-z
• Title of Journal or Parent Work: Current Hypertension Reports
• Volume: 21
• Issue: 5
• Start Page: 34
• End Page: 34
• Grant/Funding Information: None declared
• Keywords: Coronary heart disease; Racial/ethnic diversity; Life Sciences & Biomedicine; Science & Technology; Racial; Obstructive sleep apnea; Hypertension; Peripheral Vascular Disease; Health; Cardiovascular System & Cardiology; Nervous system; ethnic disparities; Apnea; Sleep; Association; Blood pressure; Scientific statement; Racial differences; Positive airway pressure
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology; Health Sciences, Health Care Management

Abstract

Purpose of Review The goal of the present review is to describe the current findings on the association of sleep with resistant hypertension (hypertension that remains uncontrolled despite the use of three or more antihypertensive medications from different classes, including a diuretic). Recent Findings Sleep disturbances, particularly obstructive sleep apnea (OSA), are highly prevalent among adults who have resistant hypertension. Randomized controlled trials indicate that treating OSA has modest effects on blood pressure lowering among those with the highest initial blood pressure. There is a paucity of research on the association of habitual sleep and other sleep disturbances with resistant hypertension. Of note, the most recent observational studies describing the association of OSA with resistant hypertension are comprised primarily of non-white race/ethnic groups who are far more likely to have resistant hypertension. Summary OSA is associated with resistant hypertension, but there is limited data on associations between sleep characteristics and resistant hypertension. Future studies should investigate whether treating OSA can reduce disparities in resistant hypertension and whether other aspects of sleep also contribute to resistant hypertension.