Is Resistance Futile?

Obstructive sleep apnea (OSA) is highly prevalent in patients with hypertension, particularly in the resistant hypertension population. A large body of evidence supports the association between OSA and incident hypertension independent of confounding risk factors. This chapter discusses the relationship between OSA and hypertension and resistant hypertension, including the prevalence, epidemiology, and pathophysiologic mechanisms linking these conditions. Treatment of OSA has been shown to reduce blood pressure in patients with hypertension, and the reduction is more marked in those with resistant hypertension. Given the high prevalence of OSA in patients with resistant hypertension, clinicians should be cognizant about screening and evaluating for OSA in patients with resistant hypertension, as treatment of OSA can improve blood-pressure control.