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In her own clinical experience, Dr.

Shivalkar said she has seen several patients who had high blood pressure that was not adequately controlled with medication.

In many cases, she discovered these patients had obstructive sleep apnea.

"After treatment with CPAP, the antihypertensive medications could usually be substantially reduced.

I am sure there are a lot of my cardiovascular colleagues out there who are often faced with such scenarios of difficult to treat hypertension.

There should be a multidisciplinary approach to this problem, with a close association with cardiovascular physicians and sleep doctors in diagnosing and treating this problem," she said.

Eighteen of the 43 sleep apnea patients in this study did not complete the six months of CPAP treatment.

Dr.

Shivalkar said that although CPAP is a simple and noninvasive solution, a number of patients do not tolerate having the face mask on during the entire sleeping period at night.

Some sleep apnea patients are treated with surgery, but Dr.

Shivalkar said there is no long term data available on the effects of surgical treatment for these patients.

Ian Wilcox, M.B., Ph.D.

from the Royal Prince Alfred Hospital Medical Centre in Newtown, Australia, who was not connected with this study, said earlier studies had produced some mixed data, and now these results move the field forward.

"This study brings it all together, particularly the treatment a...

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