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First published online April 11, 2008
Experimental Biology and Medicine 233:627-650 (2008)
doi: 10.3181/0710-MR-267
© 2008 by the Society for Experimental Biology and Medicine
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MINIREVIEW

Intermittent Hypoxia: Cause of or Therapy for Systemic Hypertension?

Tatiana V. Serebrovskaya*,1, Eugenia B. Manukhina{dagger}, Michael L. Smith{ddagger}, H. Fred Downey{ddagger} and Robert T. Mallet{ddagger}

* Bogomoletz Institute of Physiology, Kiev, Ukraine; {dagger} Institute of General Pathology and Pathophysiology, Moscow, Russia; and {ddagger} University of North Texas Health Science Center, Fort Worth, Texas

To whom requests for reprints should be addressed at 1 Bogomoletz Institute of Physiology, 4 Bogomoletz St., Kiev 01024, Ukraine. E-mail: sereb{at}biph.kiev.ua

During acute episodes of hypoxia, chemoreceptor-mediated sympathetic activity increases heart rate, cardiac output, peripheral resistance and systemic arterial pressure. However, different intermittent hypoxia paradigms produce remarkably divergent effects on systemic arterial pressure in the post-hypoxic steady state. The hypertensive effects of obstructive sleep apnea (OSA) vs. the depressor effects of therapeutic hypoxia exemplify this divergence. OSA, a condition afflicting 15–25% of American men and 5–10% of women, has been implicated in the pathogenesis of systemic hypertension and is a major risk factor for heart disease and stroke. OSA imposes a series of brief, intense episodes of hypoxia and hypercapnia, leading to persistent, maladaptive chemoreflex-mediated activation of the sympathetic nervous system which culminates in hypertension. Conversely, extensive evidence in animals and humans has shown controlled intermittent hypoxia conditioning programs to be safe, efficacious modalities for prevention and treatment of hypertension. This article reviews the pertinent literature in an attempt to reconcile the divergent effects of intermittent hypoxia therapy and obstructive sleep apnea on hypertension. Special emphasis is placed on research conducted in the nations of the former Soviet Union, where intermittent hypoxia conditioning programs are being applied therapeutically to treat hypertension in patients. Also reviewed is evidence regarding mechanisms of the pro- and anti-hypertensive effects of intermittent hypoxia.

Key Words: angiogenesis • hypertension • intermittent hypoxia • nitric oxide • obstructive sleep apnea • reactive oxygen species




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[Abstract] [Full Text] [PDF]


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