Trial reportJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2014
Association of severe obstructive sleep apnea and elevated blood pressure despite antihypertensive medication use.
Trial report in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 3 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- Association between obstructive sleep apnea and resistant hypertension: systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association.Hypertension (Dallas, Tex. : 1979) · 2018Guideline
- Association of obstructive sleep apnea with hypertension: A systematic review and meta-analysis.Journal of global health · 2018Pooled it
- Role of endothelial function determined by asymmetric dimethylarginine in the prediction of resistant hypertension: A subanalysis of ReHOT trial.Journal of clinical hypertension (Greenwich, Conn.) · 2020Trial
- Article
- Sleep-Disordered Breathing and Hypertension-A Systematic Review.Journal of clinical medicine · 2025Review
- Cone beam computed tomography based upper airway measurement after orthognathic surgery: a comparative evaluation of different imaging software.Scientific reports · 2025Article
- Obstructive Sleep Apnea and Stroke: Determining the Mechanisms Behind their Association and Treatment Options.Translational stroke research · 2024Review
- The prevalence of obstructive sleep apnea in Japanese asthma patients.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2024Article
- Pharmacological interventions for the treatment of obstructive sleep apnea syndrome.Frontiers in medicine · 2024Article
- International Consensus Statement on Obstructive Sleep Apnea.International forum of allergy & rhinology · 2023Review
- Comparison of polysomnographic and cephalometric parameters based on positional and rapid eye movement sleep dependency in obstructive sleep apnea.Scientific reports · 2022Article
- Continuous positive airway pressure use: how much is enough?Hypertension research : official journal of the Japanese Society of Hypertension · 2022Article
- Changing Effects of Minimally Invasive Surgical Intervention on ALT, AST, and UA in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome.International journal of clinical practice · 2022Article
- Poor blood pressure control following subarachnoid hemorrhage in patients with sleep apnea.Sleep & breathing = Schlaf & Atmung · 2021Article
- Higher Apnea-Hypopnea Index (AHI) and Oxygen Desaturation Index (ODI) Were Independently Associated with Increased Risks of Hypertension in Patients with T2DM: A Cross-Sectional Study.International journal of hypertension · 2021Article
- The Relationship Between Primary Sleep Disorders and Temporomandibular Disorders: An 8-Year Nationwide Cohort Study in South Korea.International journal of general medicine · 2021Article
- Machine and Deep Learning in Molecular and Genetic Aspects of Sleep Research.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021Review
- Lacune is the stroke subtype linked to obstructive sleep apnea.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2020Article
- Association of Obstructive Sleep Apnea With Nighttime Blood Pressure in African Americans: The Jackson Heart Study.American journal of hypertension · 2020Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
rationaleWe hypothesized that untreated severe obstructive sleep apnea (OSA) is associated with elevated ambulatory blood pressure (BP) in subjects with high cardiovascular disease (CVD) risk despite medical management.
methodsData from the baseline examination of the Heart Biomarker Evaluation in Apnea Treatment (HeartBEAT) study, a 4-site randomized controlled trial were analyzed. Individuals with moderate-severe OSA (apnea hypopnea index, AHI = 15-50) and cardiovascular risk were recruited from cardiology practices. Those with hypertension were included. Intensive antihypertensive regimen (IAR) was defined as ≥ 3 antihypertensives including a diuretic. Definitions were: controlled BP (BP < 130/80), uncontrolled elevated BP (BP ≥ 130/80 not on IAR) and resistant elevated BP (BP ≥ 130/80 mm Hg despite IAR). Associations of untreated severe OSA (AHI ≥ 30) and uncontrolled and resistant elevated BP were evaluated using logistic regression analyses adjusted for age, sex, race, body mass index, smoking status, diabetes, and CVD.
resultsAmong the 284 participants (mean age 63.1 ± 7.2 years, 23.6% with severe OSA), 61.6% had controlled BP, 28.5% had uncontrolled elevated BP, and 9.9% had resistant elevated BP. Among participants prescribed IAR, resistant elevated BP was more prevalent in those with severe compared to moderate OSA (58.3% vs. 28.6%, p = 0.01). Participants with severe OSA had a 4-fold higher adjusted odds of resistant elevated BP (OR 4.1, 95% CI: 1.7-10.2), a finding not reproduced in the absence of IAR use.
conclusionsAmong patients with increased cardiovascular risk and moderate to severe OSA, untreated severe compared to moderate OSA was associated with elevated BP despite IAR suggesting untreated severe OSA contributes to poor BP control despite aggressive medication use. COMMENTARY: A commentary on this article appears in this issue on page 845.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.