Sleep Apnea, Hypertension and the Sympathetic Nervous System in the Adult Population
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, NY 55901, USA
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J. Clin. Med. 2020, 9(2), 591; https://doi.org/10.3390/jcm9020591
Received: 28 January 2020 / Revised: 16 February 2020 / Accepted: 19 February 2020 / Published: 21 February 2020
(This article belongs to the Special Issue Autonomic Nervous System: From Bench to Bedside)
Sleep apnea is very common in patients with cardiovascular disease, especially in patients with hypertension. Over the last few decades a number of discoveries have helped support a causal relationship between the two and even resistant hypertension. The role neurogenic mechanisms play has gathered more attention in the recent past due to their immediate bedside utility. Several innovative discoveries in pathogenesis including those exploring the role of baroreflex gain, cardiovascular variability, chemoreceptor reflex activation and the sympathetic nervous system have emerged. In this review, we discuss the epidemiology of sleep apnea and hypertension and the pathogenic mechanisms contributing to neurogenic hypertension. Furthermore, recent management strategies in addition to continuous positive airway pressure (CPAP), such as upper airway stimulation and renal denervation that target these pathogenic mechanisms, are also discussed.
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Keywords:
sleep apnea; obstructive sleep apnea; hypertension; neurogenic; resistant hypertension; sympathetic nervous system
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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MDPI and ACS Style
Venkataraman, S.; Vungarala, S.; Covassin, N.; Somers, V.K. Sleep Apnea, Hypertension and the Sympathetic Nervous System in the Adult Population. J. Clin. Med. 2020, 9, 591. https://doi.org/10.3390/jcm9020591
AMA Style
Venkataraman S, Vungarala S, Covassin N, Somers VK. Sleep Apnea, Hypertension and the Sympathetic Nervous System in the Adult Population. Journal of Clinical Medicine. 2020; 9(2):591. https://doi.org/10.3390/jcm9020591
Chicago/Turabian StyleVenkataraman, Shreyas; Vungarala, Soumya; Covassin, Naima; Somers, Virend K. 2020. "Sleep Apnea, Hypertension and the Sympathetic Nervous System in the Adult Population" J. Clin. Med. 9, no. 2: 591. https://doi.org/10.3390/jcm9020591
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