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To the Editor: The JNC 7 report¹ on hypertension made only passing reference to sleep apnea as a treatable cause of hypertension. Obstructive sleep apnea is an independent risk factor for hypertension,² as well as other heart disease.³ It is particularly likely to be present in patients with drug-resistant hypertension.⁴ Furthermore, effective treatment of sleep apnea lowers blood pressure in the absence of specific antihypertensive treatment.⁵

Barbara Phillips, MD, MSPH
Department of Internal Medicine
University of Kentucky
Lexington

1. Chobanian AV, Bakris GL, Black HR, et al, and the National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560-2572. FREE FULL TEXT 2. Nieto FJ, Young TB, Lind BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study: Sleep Heart Health Study. JAMA. 2000;283:1829-1836. FREE FULL TEXT 3. Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up. Am J Respir Crit Care Med. 2002;166:159-165. FREE FULL TEXT 4. Logan AG, Perlikowski SM, Mente A, et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens. 2001;19:2271-2277. FULL TEXT | ISI | PUBMED 5. Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet. 2002;359:204-210. FULL TEXT | ISI | PUBMED

JAMA. 2003;290:1314.

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