Many persons with sleep apnea are hypertensive. Forty-two subjects of
similar age and weight were divided into four groups of hypertensives
and normotensives with and without sleep apnea. All subjects had heart
rate, blood pressure (BP), baroreflex sensitivity and presser sensiti
vity to phenylephrine measured while breathing room air or 15% oxygen.
Hypoxia raised heart rate and lowered BP in all groups (p < 0.001), w
ith the greatest hypotensive effect among hypertensives. Hypertensives
had blunted baroreflex sensitivity, and breathing a hypoxic mixture l
owered baroreflex sensitivity of all four groups (p = 0.008). The apne
ic subjects tended to lower their baroreflex sensitivity more in respo
nse to hypoxia and also had an enhanced presser response to phenylephr
ine, whether breathing room air or 15% oxygen. Episodes of sleep apnea
lead to hypoxia, an initial period of hypotension and a subsequent in
crease in sympathetic nervous activity. Our studies suggest that apnei
cs could have an exaggerated pressor sensitivity to norepinephrine. Th
ey might also have difficulty returning BP to normal levels, because h
ypoxia impaired baroreflexes.