The Use of Precision Medicine to Manage Obstructive Sleep Apnea Treatment in Patients with Resistant Hypertension: Current Evidence and Future Directions

Purpose of Review The significant prevalence of resistant hypertension (RH) and the high cardiovascular risk of the population of patients with RH have indicated the necessity to identify its main causes. Among these, obstructive sleep apnea (OSA) is considered the most well-established cause. Recen...

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Bibliographic Details
Published in:Current hypertension reports 2018-07, Vol.20 (7), p.60-7, Article 60
Main Authors: Sapiña, Esther, Torres, Gerard, Barbé, Ferran, Sánchez-de-la-Torre, Manuel
Format: Article
Language:English
Subjects:
Cardiology
Continuous positive airway pressure
Family Medicine
General Practice
Hypertension
Internal Medicine
Medicine
Medicine & Public Health
Metabolic Diseases
Nephrology
Primary Care Medicine
Resistant Hypertension (L Drager
Section Editor
Sleep apnea
Topical Collection on Resistant Hypertension
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Summary:Purpose of Review The significant prevalence of resistant hypertension (RH) and the high cardiovascular risk of the population of patients with RH have indicated the necessity to identify its main causes. Among these, obstructive sleep apnea (OSA) is considered the most well-established cause. Recent Findings In recent years, several studies have shown a beneficial effect of continuous positive airway pressure (CPAP) treatment on blood pressure (BP), but this effect exhibits great variability. The diagnosis and management of OSA in patients with RH suggest a clinical option for a phenotype of patients for whom therapeutic strategies are limited to pharmaceutical therapy and renal denervation. However, the great variability in the CPAP response has increased the necessity to develop instruments to identify patients who could benefit from a treatment that reduces BP. Summary Application of precision medicine to these patients should be considered as a first-line intervention to avoid the prescription of ineffective treatments and excessive consumption of pharmacological drugs that do not ameliorate the cardiovascular risk.
ISSN:1522-6417
1534-3111
DOI:10.1007/s11906-018-0853-3