Systemic and Pulmonary Arterial Hypertension in Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is an independent risk factor for systemic and pulmonary arterial hypertension. Sympathetic activation, caused by recurrent hypoxemia, is the most important pathomechanism for systemic hypertension, which is probably the most important link concerning the markedly increased mortality and morbidity in untreated OSA patients. Effective continuous positive airway pressure (CPAP) treatment substantially reduces blood pressure in hypertensive OSA patients. Similarly, recurrent hypoxemia causing pulmonary arteriolar vasoconstriction mediates development of pulmonary hypertension. Limited data suggest that use of CPAP improves pulmonary arterial hypertension.