Saturday, September 8, 2012

treating high blood pressure without medication side effects


High blood pressure is common and is associated with a higher risk of heart attacks and strokes.


Sleep apnea is common and contributes to the development of high blood pressure.

The  diagnosis and treatment of  obstructive sleep is simple , effective with less side effects than any blood pressure lowering medication .
 Plus , you wake up feeling better


I looked up Obstructive sleep apnea in PUBMED and found a list of 24,784 articles . I reviewed the first 100 looking for more information on the metabolic effects of Obstructive Sleep Apnea. One well constructed sentence high lighted in the article below does a good job explaining the underlying correctable problems of sleep apnea.

"Some of the mechanisms by which sleep apnea contributes to the development of hypertension are intermittent hypoxia and/or increased upper airway resistance associated with sleep apnea that induces a sustained increase in sympathetic nervous system activity."

In fact almost every sentence is worth reading . 
 "The prevalence of sleep apnea syndrome is relatively high in population (5%)."

"There is an increased rate of car accidents in the subjects with OSA compared to those who don't have this syndrome (31% versus 6%)." 

"The association between OSA and hypertension has been much debated. The prevalence of hypertension among patients with OSA varies between 50-58%, while the prevalence of OSA in hypertensive patients is 30%. 
A particular association is OSA and resistant hypertension, i.e. blood pressure that remains above goal in spite of the concurrent use of three antihypertensive agents of different classes, one to be a diuretic and all pharmacological agents being prescribed at recommended doses."


"The impact of OSA on mortality is also given by its association with a significant number of cardiovascular diseases".

*
Pneumologia. 2011 Oct-Dec; vol. 60(4) pp. 202-7
[Sleep apnea syndrome -- cause of resistance to treatment of arterial hypertension].
Frenţ S, Tudorache V, Ardelean C, Dimitriu D, Lighezan D, Gaiţă D, Mihăicuţă S
The prevalence of sleep apnea syndrome is relatively high in population (5%). The mortality is significantly higher in those with apnea-hypopnea index >20. There is an increased rate of car accidents in the subjects with OSA compared to those who don't have this syndrome (31% versus 6%). The impact of OSA on mortality is also given by its association with a significant number of cardiovascular diseases. The association between OSA and hypertension has been much debated. The prevalence of hypertension among patients with OSA varies between 50-58%, while the prevalence of OSA in hypertensive patients is 30%. A particular association is OSA and resistant hypertension, i.e. blood pressure that remains above goal in spite of the concurrent use of three antihypertensive agents of different classes, one to be a diuretic and all pharmacological agents being prescribed at recommended doses. Secondary causes of hypertension are common in patients with resistant hypertension. Among these causes, one of the most frequent is sleep apnea syndrome. Some of the mechanisms by which sleep apnea contributes to the development of hypertension are intermittent hypoxia and/or increased upper airway resistance associated with sleep apnea that induces a sustained increase in sympathetic nervous system activity. Treatment of sleep apnea with continuous positive airway pressure devices (CPAP) improves blood pressure control, although the benefit of CPAP evaluated in clinical trials is variable.

Comment. 
I was impressed by the number of articles discussing the various effect of Obstructive Sleep Apnea on the heart. It is listed as an independent risk factor for cardiovascular impairment .It is associated with structural and functional changes in the heart. Electrical conduction problems  with Rhythm disturbances such as Atrial fibrillation and heart block.  
Pre-diabetes, Type 2 Diabetes and elements of the Metabolic Syndrome are associated with this disorder.

I personally believe that the diagnosis of obstructive Sleep Apnea is delayed for years because almost everyone snores and the other vague symptoms of tiredness , daytime sleepiness especially when driving a car are just overlooked by patients and doctors . The association with multiple  other serious disease states are often just not linked to this disorder. 
I will present a case tomorrow that exhibits bits and pieces of all of the above.
Have fun , Be Smart and Think of Sleep Apnea
David Calder,MD

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Your comments and questions are appreciated. David Calder,MD