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Sleep Apnea and Hypertension in the Elderly

Sleep Apnea and Hypertension in the Elderly Purpose of ReviewThe cardiovascular morbidity associated with obstructive sleep apnea (OSA) changes with aging. This review addresses unique aspects of OSA-associated hypertension and cardiovascular disease (CVD) in the elderly.Recent FindingsThe risk of hypertension and CVD in OSA diminishes with aging. The standard apnea hypopnea index cut-offs for OSA diagnosis and severity do not predict CVD or mortality in the elderly. Further, the impact of continuous positive airway pressure (CPAP) treatment on hypertension and mortality is inconsistent in this population. A therapeutic effect of CPAP is noted in some studies in subsets of elderly with high CPAP adherence.SummaryAging-related physiological changes in upper airway function and ventilatory control function modify the impact of OSA on hypertension and CVD. Future research should identify common endotypes of OSA and optimal OSA severity metrics from polysomnography to inform treatment algorithms for the elderly. Finally, promotion of CPAP adherence in this population may improve CVD outcomes. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Sleep Medicine Reports Springer Journals

Sleep Apnea and Hypertension in the Elderly

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Publisher
Springer Journals
Copyright
Copyright © This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2021
eISSN
2198-6401
DOI
10.1007/s40675-021-00211-4
Publisher site
See Article on Publisher Site

Abstract

Purpose of ReviewThe cardiovascular morbidity associated with obstructive sleep apnea (OSA) changes with aging. This review addresses unique aspects of OSA-associated hypertension and cardiovascular disease (CVD) in the elderly.Recent FindingsThe risk of hypertension and CVD in OSA diminishes with aging. The standard apnea hypopnea index cut-offs for OSA diagnosis and severity do not predict CVD or mortality in the elderly. Further, the impact of continuous positive airway pressure (CPAP) treatment on hypertension and mortality is inconsistent in this population. A therapeutic effect of CPAP is noted in some studies in subsets of elderly with high CPAP adherence.SummaryAging-related physiological changes in upper airway function and ventilatory control function modify the impact of OSA on hypertension and CVD. Future research should identify common endotypes of OSA and optimal OSA severity metrics from polysomnography to inform treatment algorithms for the elderly. Finally, promotion of CPAP adherence in this population may improve CVD outcomes.

Journal

Current Sleep Medicine ReportsSpringer Journals

Published: Sep 1, 2021

Keywords: Sleep apnea; Hypertension; Elderly

References