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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is clear evidence for obstructive sleep apnea as an independent cause of arterial hypertension. We report a case of intracranial hemorrhage with systemic hypertension resistant to antihypertensive medication, which could only be adjusted after effective treatment of coexisting sleep-disordered breathing. The 36 year old male (body mass index 31 kg/m2) was admitted to hospital three weeks before for intracranial bleeding at the left external capsule. Diagnosis of primary hypertension was made after extensive work-up in the acute hospital. Blood pressure was adjusted with five-fold antihypertensive medication at the time of admission to neurological rehabilitation, but was still elevated with "non-dipping" as determined by long-term measurement despite medications above the recommended dosages. Polysomnography confirmed the diagnosis of obstructive sleep apnea. 10 days after initiation of treatment with nasal CPAP blood pressure control was easier with normal dipping at night. Medication could be reduced during rehabilitation with further reduction after discharge. Moderate obstructive sleep apnea appears to be the cause of severe hypertension resistant to pharmacological therapy in this patient. The case underlines the impact of diagnosis and treatment of sleep-disordered breathing for the secondary prevention of stroke.
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PMID:[Obstructive sleep apnea syndrome. A probably cause of therapy refractory hypertension in intracerebral hemorrhage]. 1055 87

The present study was designed to estimate the effectiveness of non-invasive auxiliary lung ventilation under continuous positive airway pressure (CPAP therapy) and phototherapy applied for the treatment of adolescents presenting with essential arterial hypertension and obstructive sleep apnea/hypopnea. It was shown that CPAP therapy decreased the level of arterial pressure (AP) either to normal or to high normal values in accordance with the patients' gender and age. It was confirmed that phototherapy produced beneficial effect on the system of circadian rhythms in the patients with essential hypertension. These findings give reason to recommend the combined application of the above methods for the treatment of adolescents with essential hypertension and obstructive sleep apnea/hypopnea. The proposed treatment makes it possible to decrease arterial pressure due to the correction of obstructive breathing disorders in sleep and to normalize the circadian rhythm system in the adolescents suffering from essential hypertension and obstructive sleep apnea/hypopnea. The clinical application of this method would permit to reduce morbidity, the incidence of disability, and mortality from complications developing in adulthood.
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PMID:[The experience with the application of the non-medication methods for the treatment of essential arterial hypertension in the adolescents presenting with obstructive sleep apnea/hypopnea syndrome]. 2553 54