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Erschienen in: Current Hypertension Reports 7/2016

01.07.2016 | Secondary Hypertension: Nervous System Mechanisms (M Wyss, Section Editor)

Obstructive Sleep Apnoea and Hypertension: the Role of the Central Nervous System

verfasst von: Luke A. Henderson, Vaughan G. Macefield

Erschienen in: Current Hypertension Reports | Ausgabe 7/2016

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Abstract

Purpose of review

Obstructive sleep apnoea (OSA) is associated with both nocturnal and daytime hypertensions which increase cardiovascular morbidity and mortality. It is thought that the repeated episodes of hypoxia and hypercapnia during nocturnal airway obstructions that characterise OSA result in increased sympathetic drive that persists during wakefulness. Although the underlying mechanisms responsible for this hypertension remain to be elucidated, several neural and humoral mechanisms have been proposed and recent evidence suggesting changes in the central nervous system may play a significant role. The purpose of this review is to explore recent evidence of central changes associated with elevated sympathetic drive in individuals with OSA.

Recent findings

Recent human brain imaging investigations and, in particular, combined microneurography recording of resting sympathetic activity with high-resolution functional magnetic resonance imaging have provided some important insights into changes in brain function and anatomy associated with resting sympathetic activity. Functional and anatomical changes occur in OSA, including in regions of the brainstem circuitry known to be responsible for setting resting sympathetic activity. Furthermore, these changes are reversed following continuous positive airway treatment in concert with reductions in resting sympathetic drive.

Summary

These resent findings suggest that the central changes may contribute significantly to the hypertension associated with OSA.
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Metadaten
Titel
Obstructive Sleep Apnoea and Hypertension: the Role of the Central Nervous System
verfasst von
Luke A. Henderson
Vaughan G. Macefield
Publikationsdatum
01.07.2016
Verlag
Springer US
Erschienen in
Current Hypertension Reports / Ausgabe 7/2016
Print ISSN: 1522-6417
Elektronische ISSN: 1534-3111
DOI
https://doi.org/10.1007/s11906-016-0665-2

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