{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:58:24Z","timestamp":1782849504420,"version":"3.54.5"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,5,28]],"date-time":"2013-05-28T00:00:00Z","timestamp":1369699200000},"content-version":"vor","delay-in-days":147,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"},{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Hypertension"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p>Hypertension (HTN) is a modifiable, highly prevalent risk factor for cardiovascular morbidity and renal dysfunction worldwide. In the United States, HTN affects one in three adults, contributes to one out of every seven deaths and to nearly half of all cardiovascular disease\u2010related deaths. HTN is considered resistant when the blood pressure remains above goal despite lifestyle modification and administration of three antihypertensive agents of different classes including a diuretic. Large population\u2010based studies have suggested that obstructive sleep apnea (OSA) is a risk factor for resistant HTN. The mechanism proposed is a pattern of intermittent hypoxia associated with hyperaldosteronism, increased sympathetic tone, endothelial dysfunction, and inflammation. In this review we discuss the association between OSA and resistant HTN, the physiologic mechanisms linking OSA with resistant HTN, and the effect of continuous positive airway pressure therapy (CPAP) on blood pressure in patients with resistant HTN. While the reduction in blood pressure with CPAP is usually modest in patients with OSA, a decrease of only a few mmHg in blood pressure can significantly reduce cardiovascular risk. Patients presenting to a center specializing in management of hypertension should be screened and treated for OSA as a potentially modifiable risk factor.<\/jats:p>","DOI":"10.1155\/2013\/193010","type":"journal-article","created":{"date-parts":[[2013,5,28]],"date-time":"2013-05-28T14:38:56Z","timestamp":1369751936000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Resistant Hypertension and Obstructive Sleep Apnea"],"prefix":"10.1155","volume":"2013","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3091-632X","authenticated-orcid":false,"given":"Akram","family":"Khan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimesh K.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"O\u2019Hearn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3278-8387","authenticated-orcid":false,"given":"Supriya","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,28]]},"reference":[{"key":"e_1_2_6_1_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.2.199"},{"key":"e_1_2_6_2_2","first-page":"103","article-title":"Vital signs: prevalence, treatment, and control of hypertension\u2014United States, 1999\u20132002 and 2005\u20132008","volume":"60","author":"Centers for Disease Control and Prevention","year":"2011","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000107251.49515.c2"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.189141"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.170308"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00035402"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00048606"},{"key":"e_1_2_6_8_2","doi-asserted-by":"crossref","first-page":"103","DOI":"10.5664\/jcsm.27435","article-title":"Effects of nocturnal continuous positive airway pressure therapy in patients with resistant hypertension and obstructive sleep apnea","volume":"5","author":"Dernaika T. 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