Man sleeping in bed

Drug Resistant Hypertension Associated with Untreated Sleep Apnea

Man sleeping in bedAccording to new research published in the Journal of Clinical Sleep Medicine, the risk of drug-resistant hypertension (high blood pressure) is significantly increased in people with severe, untreated obstructive sleep apnea.

According to the first author of the study, Dr. Harneet Walia, an assistant professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, “Our findings suggest that severe obstructive sleep apnea contributes to poor blood pressure control despite aggressive medication use.”

An Intensive Drug Regimen

Researchers recruited patients who had both severe or moderate obstructive sleep apnea and cardiovascular risk. Nearly 300 patients were recruited from cardiology practices. They found that 61.6% of subjects recruited had controlled blood pressure, while 28.5% had uncontrolled, elevated blood pressure, and 9.9% had resistant elevated blood pressure. Resistant elevated blood pressure was defined as elevated blood pressure despite the use of an intensive antihypertensive regimen (IAR) of three or more antihypertensives, including a diuretic.

After controlling for many potential confounding factors, such as age, race, sex, body mass index, smoking status, diabetes, and cardiovascular disease, they found that severe obstructive sleep apnea was associated with 4.12 times greater odds of developing resistant elevated blood pressure.

Dr. Walia noted that severe sleep apnea seemed to be thwarting the best practices in medicine for the control of high blood pressure, “Even under the close care of a cardiologist following national guidelines for treatment of cardiovascular risk and comprehensive medication regimens, severe levels of obstructive sleep apnea versus a moderate level of OSA appear to be contributing to suboptimal blood pressure control.”

Clinical Relevance

Dr. Walia said the research “is an important finding from a clinical perspective as poor blood pressure control in patients taking multiple antihypertensive medications makes them particularly vulnerable to increased cardiovascular risk.” This underscores again the importance of talking to your doctor about sleep apnea if you have been diagnosed with high blood pressure.

It also reminds us how important it is to reduce or eliminate sleep apnea. If you have been prescribed a sleep apnea treatment but aren’t using it because it is uncomfortable or inconvenient, we have a better option. Please call 402-493-4175 for an appointment with an Omaha sleep dentist at the Advanced Dental Sleep Treatment Center.