Obstructive sleep apnea and arterial hypertension

Background In Germany, around 19 million patients are diagnosed with arterial hypertension (aHT). The intersection between patients with aHT and obstructive sleep apnea (OSA) is large. Awakenings and hypoxemia in the context of OSA can lead to increased sympathetic tone and endothelial dysfunction, and thus aHT. Question This review article is aimed at describing the connections between OSA and aHT as well as the different treatment options. Methods A literature search was conducted in the PubMed database for original and review articles published up to 2021. Results Obstructive sleep apnea can cause aHT as well as the deterioration of existing aHT. Those affected benefit from continuous positive airway pressure (CPAP) treatment with an average reduction in systolic blood pressure of -4.4 mm Hg and diastolic blood pressure of -2.9 mm Hg. Predictors of a reduction of blood pressure using CPAP are young age, therapy-resistant aHT, severe OSA-related oxygen desaturation, and a "nondipping" blood pressure pattern. Conclusions Adequate treatment of aHT often requires a multimodal approach. Besides therapy with antihypertensive medication and a change of lifestyle, practitioners should also consider the diagnosis and possible treatment of OSA.