Situation: An hypertensive with obstructive sleep apnea was not responding to CPAP.
Reaction: Oh my God! Why was anti hypertensive drug not started?
Lesson: Make sure that all hypertensives with OSA are given anti HT drugs in addition to CPAP. In a randomized crossover trial of 23 patients with OSA and systemic hypertension, an antihypertensive medication (valsartan 160 mg per day) lowered the mean 24-hour blood pressure significantly more than CPAP therapy alone
(Am J Respir Crit Care Med 2010;182(7):954-60).
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