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Old 12-30-2011
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Sphygmomanometer Obstructive Sleep Apnea and Systemic Hypertension!

UW says Obstructive sleep apnea leads to Systemic Hypertension. Can someone explain the pathogenesis behind?

thanks a ton.
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obstructive sleep apnea leads to complications that's pulmonary hypertension and cor pulmonale...because of hypoxia

Where did you get this?
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Old 12-30-2011
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Default Yes...

It causes a secondary pulmonary hypertension due to hypoxemia.
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Help I remember...

i remeber have read of it in FA or in BRS... But goes like this:

Hypoxemia leads to vasoconstriction, vasoconstriction lead to an increase in pulmonary arterial pressure; then, this leads to an increase work of the right side of the heart against the higher resistance... all this leading to pulmonary hypertension.


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Kindly refer to Page 127 Behavioral Sciences Kaplan notes. It is well mentioned and I am sure I did I question too in UW in which systemic HTN was a complication
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here u go

http://www.aafp.org/afp/2002/0115/p229.html
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Help Hypoxia...

I found two articles that may give you the answer:

"The pathogenesis of hypertension in OSA patients involves sympathetic hyperactivity secondary to intermittent hypoxia, decreased baroreflex sensitivity, endothelial dysfunction, neurohumoral mechanisms involving the hypothalamic-pituitary-adrenal axis, and increased platelet activation."

http://erm.ersjournals.com/content/ermsa/1/SEC13.short

"Considering the preponderance of the evidence, most experts agree that OSA is not only associated with hypertension but plays a causal role in its development. (...) While the exact pathways are yet to be confirmed, activation of a number of neural, humoral, metabolic, and inflammatory processes are all thought to play a role.
BP elevation is related to an elevation in peripheral vascular resistance (PVR). (...) Over time, vascular walls may become thickened, hardened, and less compliant because of remodeling and fibrosis, which increases PVR. (...) In the acute setting, recurrent episodes of hypoxemia, hypercapnia, and increasingly negative intrathoracic pressure lead to increased levels of endothelin (a potent vasoconstrictor), an effect seen more in OSA patients than in control subjects. This hypoxemia also increases circulating reactive oxygen species which can induce vascular inflammatory responses. (...)"

http://ajrccm.atsjournals.org/content/184/11/1229.full

I Hope it can help...
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Quote:
Originally Posted by indigo View Post
Kindly refer to Pg 127 Behav Sciences Kaplan notes.It is well mentioned and I am sure I did I question too in UW in which systemic HTN was a complication
Yes you are right...Kaplan behavioral science says ...high risk of sudden death during sleep, development of nocturnal hypoxia, pulmonary and systemic hypertension with elevation of diastolic pressure..
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