Since the new hypertension guideline from the American College of Cardiology and the American Heart Association was released in November 2017, the way physicians diagnose and treat high blood pressure has changed. And with the new guideline comes a section on sleep apnea. Have you seen this new guideline yet?
What does the guideline say?
The new guideline lowers the blood pressure cutoff for a hypertension diagnosis from 140/90 mm Hg to 130/80 mm Hg. And instead of using the term prehypertension, they recommend using stage 1 hypertension for levels of 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic pressure and 120 to 129 mm Hg systolic and diastolic of less than 80 as “elevated.”
For obstructive sleep apnea, it is a risk factor for several cardiovascular diseases, including hypertension, coronary and cerebrovascular diseases. Studies have shown that the presence of OSA is associated with an increased risk of hypertension. It has also been hypothesized that treatment for sleep apnea will have more pronounced effects on BP reduction in resistant hypertension.
What does this mean for dentists?
This means we need to be extra cautious of our patients. Now that the level for hypertension has lowered, we need to pay attention to how that affects sleep apnea and vice versa. The guideline also recommends CPAP therapy as an effective form of treatment for improving sleep apnea, but studies that have been conducted showed that its effects on BP were only small.
Through the guideline, we can accept that CPAP therapy is an option, but what about oral appliance therapy? With the number of individuals with hypertension now at almost 50 percent, we need to pay closer attention to OSA and how it affects hypertension and high blood pressure.
Talk to your patients, include information on the health questionnaire and provide educational materials so that you can continue to provide your patients with the care they need and deserve. On top of that continue to complete advanced education to remain up-to-date with important information.