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Resistant hypertension and sleep

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https://www.readbyqxmd.com/read/29241747/pathophysiology-of-the-metabolic-syndrome
#1
Emma McCracken, Monica Monaghan, Shiva Sreenivasan
The metabolic syndrome-otherwise called syndrome X, insulin resistance syndrome, Reaven syndrome, and "the deadly quartet"-is the name given to the aggregate of clinical conditions comprising central and abdominal obesity, systemic hypertension, insulin resistance (or type 2 diabetes mellitus), and atherogenic dyslipidemia. It is a prothrombotic and proinflammatory state characterized by increased inflammatory cytokine activity. In addition to inflammatory dermatoses such as psoriasis, lichen planus, and hidradenitis suppurativa, metabolic syndrome is also commonly associated with accelerated atherosclerotic cardiovascular disease, hyperuricemia/gout, chronic kidney disease, and obstructive sleep apnea...
January 2018: Clinics in Dermatology
https://www.readbyqxmd.com/read/29212081/in-patients-with-chronic-kidney-disease-short-term-blood-pressure-variability-is-associated-with-the-presence-and-severity-of-sleep-disorders
#2
Martino F Pengo, Donatella Ioratti, Valeria Bisogni, Verdiana Ravarotto, Barbara Rossi, Luciana Bonfante, Francesca Simioni, Federico Nalesso, Giuseppe Maiolino, Lorenzo A Calò
BACKGROUND/AIMS: In chronic kidney disease (CKD) patients blood pressure variability (BPV) is associated with poor outcome. Sleep disturbances alter BP profiles in hypertensives but their influence on BPV in CKD patients is unknown. We screened a cohort of CKD/ESRD patients to investigate whether sleep quality impacts on BPV. METHODS: Consecutive CKD patients' sleep quality was assessed using validated questionnaires (Epworth Sleepiness Scale-ESS); International Restless legs scale-IRLS; Functional Outcomes of Sleep Questionnaire-FOSQ: Insomnia Severity Index-ISI; STOP-Bang)...
November 28, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29211322/perivascular-adipose-tissue-and-the-dynamic-regulation-of-kv-7-and-kir-channels-implications-to-resistant-hypertension
#3
Maik Gollasch, Donald G Welsh, Rudolf Schubert
Resistant hypertension is defined as high blood pressure that remains uncontrolled despite treatment with at least three antihypertensive drugs at adequate doses. Resistant hypertension is an increasingly common clinical problem in older age, obesity, diabetes, sleep apnea, and chronic kidney disease. Although the direct vasodilator minoxidil was introduced in the early 1970s, only recently has this drug been shown to be particularly effective in a subgroup of patients with treatment-resistant or uncontrolled hypertension...
December 6, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29202496/primary-aldosteronism-and-obstructive-sleep-apnea-is-this-a-bidirectional-relationship
#4
Aleksander Prejbisz, Sylwia Kołodziejczyk-Kruk, Jacques W M Lenders, Andrzej Januszewicz
It has been suggested that the high prevalence of obstructive sleep apnea (OSA) in resistant hypertension (RHT) may be related to the high prevalence of primary aldosteronism (PA) in patients with RHT. It has been also hypothesized that the relationship between aldosterone and OSA might be bidirectional. In patients with RHT, it has been shown that aldosterone levels correlate with severity of OSA and that blockade of aldosterone reduces the severity of OSA. It has been postulated that aldosterone worsens OSA by promoting accumulation of fluid, which shifted in the supine position to the neck, contributes to increased upper airway resistance...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29178489/daily-inspiratory-muscle-training-lowers-blood-pressure-and-vascular-resistance-in-healthy-men-and-women
#5
Claire M DeLucia, Roxanne M De Asis, E Fiona Bailey
Previous work has shown inspiratory muscle training (IMT) lowers blood pressure after just six weeks, identifying IMT as a potential therapeutic to prevent/treat hypertension. Here, we explore the effects of IMT on respiratory muscle strength and select cardiovascular parameters in recreationally active men and women. Subjects were randomly assigned to IMT (n = 12, 75% maximal inspiratory pressure) or sham training (n = 13, 15% maximum inspiratory pressure) groups and underwent a 6-week intervention comprising 30 breaths day-1 , 5 days week-1 ...
November 24, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/29151428/continuous-positive-airway-pressure-in-patients-with-obstructive-sleep-apnea-and-non-alcoholic-steatohepatitis-a-systematic-review-and-meta-analysis
#6
Gonzalo Labarca, Rodrigo Cruz, Jorge Jorquera
STUDY OBJECTIVES: Several studies have reported an association between obstructive sleep apnea (OSA) and several extra-pulmonary issues, such as arterial hypertension and insulin resistance. In recent years, the associations between OSA, non-alcoholic fatty liver disease, and non-alcoholic steatohepatitis (NASH) have been published; however, there is a gap between experimental and clinical studies regarding the efficacy of continuous positive airway pressure (CPAP) treatment in patient populations with these conditions...
November 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29114876/translating-carotid-body-function-into-clinical-medicine
#7
Rodrigo Iturriaga
The carotid body (CB) is considered the main O2 chemoreceptor, which contributes to the cardiorespiratory homeostasis and ventilatory acclimatization. In clinical medicine, the most common pathology associated with the CB are tumours. However, a growing body of evidences supports the novel idea that an enhanced CB chemosensory discharge contributes to the autonomic dysfunction and pathological consequences in obstructive sleep apnoea (OSA), hypertension, systolic heart failure (HF) and cardiometabolic diseases...
November 8, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29106789/depression-and-obstructive-sleep-apnea
#8
(no author information available yet)
OBJECTIVE: Obstructive sleep apnea (OSA), is described as intermittent interruptions or reductions in airflow which are initiated by an incomplete or complete collapse of the upper airways despite respiratory effort. When left untreated, OSA is connected with comorbid conditions, such as cardiovascular and metabolic illnesses. METHOD: The PubMed database was used to examine papers published until April 2017 using the subsequent terms: "obstructive sleep apnea" or "obstructive sleep apnoea" and "depression" in successive combination with "CPAP (continuous positive airway pressure)", "therapy", "pharmacotherapy", "psychotherapy", "cognitive behavioral therapy" or "quality of life"...
October 6, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/29094913/secondary-hypertension-discovering-the-underlying-cause
#9
REVIEW
Lesley Charles, Jean Triscott, Bonnie Dobbs
Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of secondary hypertension vary by age. The most common causes in children are renal parenchymal disease and coarctation of the aorta. In adults 65 years and older, atherosclerotic renal artery stenosis, renal failure, and hypothyroidism are common causes...
October 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29080064/ambulatory-screening-for-obstructive-sleep-apnea-in-patients-with-resistant-arterial-hypertension
#10
Monika Kamasová, Jan Václavík, Tomáš Václavík, Milada Hobzová, Eva Kociánová, Miloš Táborský
OBJECTIVE: Obstructive sleep apnea (OSA) is one of the most common causes of secondary arterial hypertension. It is important to rule out OSA as a cause of resistant hypertension. The ApneaLink device is a simple and cost-efficient outpatient examination, but its usefulness in screening OSA in resistant hypertension has not yet been evaluated. METHODS: A total of 69 patients with resistant arterial hypertension were enrolled. Patients underwent a physical examination, including the use of ApneaLink, followed by respiratory polygraphy...
October 27, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29047083/altered-redox-balance-in-the-development-of-chronic-hypoxia-induced-pulmonary-hypertension
#11
Nikki L Jernigan, Thomas C Resta, Laura V Gonzalez Bosc
Normally, the pulmonary circulation is maintained in a low-pressure, low-resistance state with little resting tone. Pulmonary arteries are thin-walled and rely heavily on pulmonary arterial distension and recruitment for reducing pulmonary vascular resistance when cardiac output is elevated. Under pathophysiological conditions, however, active vasoconstriction and vascular remodeling lead to enhanced pulmonary vascular resistance and subsequent pulmonary hypertension (PH). Chronic hypoxia is a critical pathological factor associated with the development of PH resulting from airway obstruction (COPD, sleep apnea), diffusion impairment (interstitial lung disease), developmental lung abnormalities, or high altitude exposure (World Health Organization [WHO]; Group III)...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28981991/sleep-behaviors-in-traditional-age-college-students-a-state-of-the-science-review-with-implications-for-practice
#12
Heather Owens, Becky Christian, Barbara Polivka
BACKGROUND AND PURPOSE: The purpose of this systematic review was to examine influences affecting sleep behavior in traditional-age college students and to advocate for improved sleep behavior assessments. DATA SOURCES: A literature search of CINAHL, MEDLINE, and PubMed databases was performed using the search terms "college students" and "sleep" in the title that were published in English from 1978 to 2016. CONCLUSIONS: The circadian clock is reset in traditional-age college students leading to delayed sleep times...
October 5, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28966594/the-role-of-the-autonomic-nervous-system-in-the-pathophysiology-of-obesity
#13
REVIEW
Daniela Guarino, Monica Nannipieri, Giorgio Iervasi, Stefano Taddei, Rosa Maria Bruno
Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS) dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28966076/sleep-apnea-metabolic-disease-and-the-cutting-edge-of-therapy
#14
Matthew Light, Karen McCowen, Atul Malhotra, Omar A Mesarwi
Obstructive sleep apnea (OSA) is common, and many cross-sectional and longitudinal studies have established OSA as an independent risk factor for the development of a variety of adverse metabolic disease states, including hypertension, insulin resistance, type 2 diabetes, nonalcoholic fatty liver disease, dyslipidemia, and atherosclerosis. Nasal continuous positive airway pressure (CPAP) has long been the mainstay of therapy for OSA, but definitive studies demonstrating the efficacy of CPAP in improving metabolic outcomes, or in reducing incident disease burden, are lacking; moreover, CPAP has variable rates of adherence...
September 28, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28934188/effect-of-aldosterone-antagonists-on-obstructive-sleep-apnea-in-patients-with-resistant-hypertension-a-systematic-review-and-meta-analysis
#15
W-D Zhang, J-W Zhang, K-F Wu, X Chen, Y-P Wang, L-H Zhou, H-T Wang, S-M Chen
No abstract text is available yet for this article.
December 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28863207/does-treating-obstructive-sleep-apnea-improve-control-of-tx-resistant-hypertension
#16
Steven Solum, Thomas Satre
Maybe. Treating obstructive sleep apnea with continuous positive airway pressure is associated with decreases in both systolic and diastolic blood pressure of 3 to 5 mm Hg in patients with treatment-resistant hypertension. The clinical significance of this small decrease hasn't been evaluated, however.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28853425/obstructive-sleep-apnea-syndrome-osas-and-cardiovascular-system
#17
Carolina Lombardi, Eleonora Tobaldini, Nicola Montano, Anna Losurdo, Gianfranco Parati
There is increasing evidence of a relationship between Obstructive Sleep Apnea (OSA) and cardiovascular diseases. The strong association between OSA and arterial hypertension, in particular in patients with resistant hypertension and/or a non-dipping profile, has been extensively reported. The relationship between OSA and high blood pressure (BP) has been found independent from a number of confounders, but several factors may affect this relationship, including age and sex. It is thus important to better assess pathophysiologic and clinical interactions between OSA and arterial hypertension, also aimed at optimizing treatment approaches in OSA and hypertensive patients with co-morbidities...
August 28, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/28844889/aiding-sleep-in-type-2-diabetes-therapeutic-considerations
#18
REVIEW
Xiao Tan, Lieve van Egmond, Colin D Chapman, Jonathan Cedernaes, Christian Benedict
Insomnia and obstructive sleep apnoea (OSA) are more prevalent in patients with type 2 diabetes than in the general population. Both insomnia and OSA have been linked to cardiometabolic alterations (eg, hypertension, increased activity of the sympathetic nervous system, and systemic insulin resistance) that can exacerbate the pathophysiology of type 2 diabetes. Improvement of sleep in patients with diabetes could therefore aid the treatment of diabetes. To help health practitioners choose the best clinical tool to improve their patients' sleep without detrimentally affecting glucose regulation, this Review critically analyses the effects of common treatments for insomnia and OSA on both sleep and glucose metabolism in patients with type 2 diabetes...
August 24, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28822508/prevalence-and-characteristics-of-resistant-hypertensive-patients-in-an-asian-population
#19
Rabia Naseem, Arsalan Majeed Adam, Fiza Khan, Adiya Dossal, Ibrahim Khan, Ammara Khan, Hannah Paul, Hafsa Jawed, Aisha Aslam, Faez Muhammad Syed, Muhammad Ahsen Niazi, Shehzeen Nadeem, Aruba Khan, Amber Zia, Mohammad Hussham Arshad
BACKGROUND: Resistant hypertension is a well-recognized clinical challenge yet there are no reported data on its prevalence in Pakistan. These patients are subjected to a higher risk of developing hypertensive complications. The objective of our study was to evaluate the prevalence and determinants of resistant hypertension in an Asian cohort of hypertensive patients. METHODS: This cross-sectional study was carried out among hypertensive patients visiting a tertiary care hospital in Karachi from September-December 2015...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28805272/clinical-phenotype-of-south-east-asian-temporomandibular-disorder-patients-with-upper-airway-resistance-syndrome
#20
David K L Tay, Kenny P Pang
OBJECTIVE: To document the clinical phenotype of temporomandibular disorder (TMD) patients with concomitant upper airway resistance syndrome (UARS) in a South East Asian population. STUDY DESIGN: A multi-center prospective series of 86 TMD patients (26 men and 60 women / mean age 35.7 years) with UARS. All had excessive daytime sleepiness, high arousal index and apnea-hypopnea index (AHI)<5 RESULTS: The mean body mass index was 20.1, mean arousal index 16.2, mean respiratory disturbance index 19...
August 14, 2017: Journal of Oral Rehabilitation
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