Association between obstructive sleep apnea and resistant hypertension: systematic review and meta-analysis

Frontiers in Medicine

Medicine

Abass Mahamoud Ahmed¹  Yuan Xiaochen¹  Salman Mohamud Nur² 

[1] Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China;Medical College, Yangzhou University, Yangzhou, Jiangsu, China;Medical College, Yangzhou University, Yangzhou, Jiangsu, China;Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, China;

关键词: obstructive sleep apnoea (OSA);    resistant hypertension;    apnea-hypoxia index (AHI);    risk factors;    hypoxia;   

DOI  :  10.3389/fmed.2023.1200952

 received in 2023-04-05, accepted in 2023-05-02,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionObstructive sleep apnea syndrome (OSAS) is a chronic disorder characterized by recurring episode obstruction and collapse of upper airways during sleep, leading to hypoxia and sleep disruption. OSAS is commonly associated with an increased prevalence of hypertension. The underlying mechanism in OSA with hypertension is related to intermittent hypoxia. This hypoxia induces endothelial dysfunction, overactivity of sympathetic effects, oxidative stress, and systemic inflammation. Hypoxemia triggers the sympathetic process's overactivity, leading to the development of resistant hypertension in OSA. Thus, we hypothesize to evaluate the association between resistant hypertension and OSA.MethodsThe PubMed, ClinicalTrails.gov, CINAHL, Google Scholar, Cochrane Library, and Science Direct databases were searched from 2000 to January 2022 for studies demonstrating the association between resistant hypertension and OSA. The eligible articles underwent quality appraisal, meta-analysis, and heterogeneity assessment.ResultsThis study comprises seven studies, including 2,541 patients ranged from 20 to 70 years. The pooled analysis of six studies demonstrated that OSAS patients with a history of increased age, gender, obesity, and smoking status are at an increased risk for resistant hypertension (OR: 4.16 [3.07, 5.64], I2:0%) than the non-OSAS patients. Similarly, the pooled effect demonstrated that patients with OSAS were at an increased risk of resistant hypertension (OR: 3.34 [2.44, 4.58]; I2:0%) than the non-OSAS patients when all associated risk factors were adjusted using multivariate analysis.ConclusionThis study concludes that OSAS patients with or without related risk factors demonstrated increased risk for resistant hypertension.

【 授权许可】

Unknown   
Copyright © 2023 Ahmed, Nur and Xiaochen.