Sympathetic overactivity and nocturnal diuresis in obstructive sleep apnea alter the response to hypertension therapy.

ABSTRACT:

Background

Obstructive sleep apnea (OSA) is associated with high blood pressure that responds poorly to usual antihypertensive therapy.

Methods and results

Forty-one subjects with OSA had 25% higher plasma norepinephrine and 42% higher epinephrine measured every 2 h over 24 h than 20 control subjects. They also excreted more sodium during sleep. This suggested that that a sympatholytic would be a more successful antihypertensive than a diuretic. To test this hypothesis we treated a second group of 23 hypertensive apneics with placebo, 6 weeks of the sympatholytic guanfacine and 6 weeks of hydrochlorothiazide in a crossover study. Guanfacine lowered 24-hour blood pressure by 9.6/6.7 mmHg, more than the 5.4/2.9 mmHg effect of hydrochlorothiazide (P < 0.05). Nighttime systolic

SUBMITTER: Ziegler MG 

PROVIDER: S-EPMC11143623 | biostudies-literature | 2024 Jun

REPOSITORIES: biostudies-literature