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International Journal of Hypertension
Volume 2011, Article ID 947246, 5 pages
http://dx.doi.org/10.4061/2011/947246
Review Article

Resistant Hypertension and Obstructive Sleep Apnea: The Sparring Partners

1Department of Cardiology, Elena Venizelou Hospital, 2 Elena Venizelou Sqr., Athens 11521, Greece
2Department of Cardiology, Metaxa Cancer Hospital, 51 Mpotassi Str., Piraeus 18537, Greece
3First Cardiology Clinic, University of Athens, Hippokration Hospital, 114 Vas. Sofias Str., Athens 11527, Greece

Received 14 October 2010; Accepted 8 December 2010

Academic Editor: Vasilios Papademetriou

Copyright © 2011 Costas Thomopoulos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Enhanced target organ damage and cardiovascular morbidity represent common issues observed in both resistant hypertension and obstructive sleep apnea. Common pathophysiological features and risk factors justify their coexistence, especially in individuals with increased upper-body adiposity. Impaired sodium handling, sympathetic activation, accelerated arterial stiffening, and impaired cardiorenal hemodynamics contribute to drug-resistant hypertension development in obstructive sleep apnea. Effective CPAP therapy qualifies as an effective “add-on” to the underlying antihypertensive pharmacological therapy, and emerging evidence underlines the favorable effect of mineralocorticoid antagonists on both resistant hypertension and obstructive sleep apnea treatment.