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(Chest. 2003;123:244-260.)
© 2003 American College of Chest Physicians

The Association of Hypertension and Secondary Cardiovascular Disease With Sleep-Disordered Breathing*

Richard A. Dart, MD, FCCP; James R. Gregoire, MD; David D. Gutterman, MD, FCCP and Steven H. Woolf, MD

* From the Department of Nephrology and Hypertension (Dr. Dart), Marshfield Clinic Marshfield, WI; Division of Hypertension and Internal Medicine (Dr. Gregoire), Mayo Clinic Rochester, MN; Medical College of Wisconsin (Dr. Gutterman), Milwaukee, WI; and Virginia Commonwealth University (Dr. Woolf), Fairfax, VA.

Correspondence to: Richard Dart, MD, Department of Nephrology, Marshfield Clinic, 1000 North Oak Ave, Marshfield, WI; e-mail: dartr{at}mfldclin.edu

We present a review of the English-language literature from 1972 through 2000 pertaining to systemic high BP in patients with sleep-disordered breathing (SDB). We reviewed studies assessing the relationship between obstructive sleep apnea, central sleep apnea or periodic breathing, and systemic high BP, and present an approach to the management of these patients. Complications of obesity and the role of the sympathetic nervous system are reviewed as well. It is the aim of these reviews to draw qualified conclusions, based on the current literature, with regard to SDB as a causative or contributory factor in systemic hypertension.

Key Words: antihypertensive drugs • central sleep apnea • obstructive sleep apnea • periodic breathing • pulmonary disease • sleep-disordered breathing • systemic high BP




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