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Review
. 2021 Mar;23(3):489-495.
doi: 10.1111/jch.14184. Epub 2021 Mar 11.

Characteristics of hypertension in obstructive sleep apnea: An Asian experience

Satoshi Hoshide  1 , Kazuomi Kario  1 , Yook-Chin Chia  2   3 , Saulat Siddique  4 , Peera Buranakitjaroen  5 , Kelvin Tsoi  6 , Jam Chin Tay  7 , Yuda Turana  8 , Chen-Huan Chen  9   10   11 , Hao-Min Cheng  9   10   11   12 , Van Minh Huynh  13 , Sungha Park  14 , Arieska Ann Soenarta  15 , Guru Prasad Sogunuru  16   17 , Tzung-Dau Wang  18   19 , Ji-Guang Wang  20
Affiliations
Review

Characteristics of hypertension in obstructive sleep apnea: An Asian experience

Satoshi Hoshide et al. J Clin Hypertens (Greenwich). 2021 Mar.

Abstract

Obstructive sleep apnea (OSA) is a risk of hypertension and is associated with cardiovascular disease (CVD) incidence. In Asian countries, the prevalence of OSA is high, as in Western countries. When blood pressure (BP) is evaluated in OSA individuals using ambulatory BP monitoring (ABPM), the BP phenotype often indicates abnormal BP variability, such as increased nighttime BP or abnormal diurnal BP variation, that is, non-dipper pattern, riser pattern, and morning BP surge, and all these conditions have been associated with increased CVD events. Asians have a higher prevalence of increased nighttime BP or morning BP surge than Westerners. Therefore, this review paper focused on OSA and hypertension from an Asian perspective to investigate the importance of the association between OSA and hypertension in the Asian population. Such abnormal BP variability has been shown to be associated with progression of arterial stiffness, and this association could provoke a vicious cycle between abnormal BP phenotypes and arterial stiffness, a phenomenon recognized as systemic hemodynamic atherothrombotic syndrome (SHATS). OSA may be one of the background factors that augment SHATS. An oxygen-triggered nocturnal oscillometric BP measurement device combined with a pulse oximeter for continuous SpO2 monitoring could detect BP variability caused by OSA. In addition to treating the OSA, accurate and reliable detection and treatment of any residual BP elevation and BP variability caused by OSA would be necessary to prevent CVD events. However, more detailed detection of BP variability, such as beat-by-beat BP monitoring, would further help to reduce CV events.

Keywords: blood pressure variability; hypertension; obstructive sleep apnea.

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Conflict of interest statement

SH has received research grants from Sanofi Co., Astellas Pharma Inc, and Novartis Pharma KK KK has received independent principal investigator–initiated research grants from Omron Healthcare Inc, Fukuda Denshi Inc, A&D Inc, Taisho Pharmaceutical Co. Inc, and Sanwa Kagaku Kenkyusho Co. Inc YC Chia has received an honorarium and sponsorships to attend conferences and seminars from Boehringer Ingelheim, Pfizer, Omron, Servier, and Xepa‐Soul and an investigator‐initiated research grant from Pfizer. CH Chen reports personal fees from Novartis, Sanofi, Daiichi Sankyo, Servier, Bayer, and Boehringer Ingelheim Pharmaceuticals Inc HM Cheng received speakers’ honoraria and sponsorships to attend conferences and CME seminars from Eli Lilly, AstraZeneca, Pfizer Inc, Bayer AG, Boehringer Ingelheim Pharmaceuticals Inc, Daiichi Sankyo, Novartis Pharmaceuticals Inc, Servier, Pharmaceuticals Corporation, Sanofi, and Takeda Pharmaceuticals International and has served as an advisor and consultant to ApoDx Technology Inc S Park reports a research grant from Sankyo and lecture fees from Sankyo, Servier, Daewoong, Donga, Takeda, Boryung, Hanmi, Pfizer, and Servier. All other authors report no potential conflicts of interest in relation to this review paper.

Figures

FIGURE 1
FIGURE 1
Prevalence of obstructive sleep apnea with AHI ≥ 15 events per hr in the population aged 30‐69 years by country or region
FIGURE 2
FIGURE 2
Obstructive sleep apnea and blood pressure phenotype observed in ABPM. ABPM indicates ambulatory blood pressure monitoring; BP, blood pressure
See this image and copyright information in PMC

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