Approach to the true resistant hypertensive and treatment approaches Matthew Weir  Journal of Indian College of Cardiology  Volume 5, Pages S33-S37 (March 2015) DOI: 10.1016/j.jicc.2015.03.020 Copyright © 2015 Terms and Conditions

Fig. 1 Plasma aldosterone levels by body weight and BP status. Journal of Indian College of Cardiology 2015 5, S33-S37DOI: (10.1016/j.jicc.2015.03.020) Copyright © 2015 Terms and Conditions

Fig. 2 Prevalence of obstructive sleep apnea. Source: Logan AG, et al. J Hypertens. 2001 Dec;19:2271–2277 Journal of Indian College of Cardiology 2015 5, S33-S37DOI: (10.1016/j.jicc.2015.03.020) Copyright © 2015 Terms and Conditions

Fig. 3 Nocturnal continuous positive airway pressure effect on (a) systolic BP and (b) diastolic BP over 24 h – baseline (white bars) and after 2 months (shaded bars). PAC – Plasma aldosterone concentration, PA – Primary aldosteronism. Source: Logan AG et al. Eur Respir J. 2003 Feb;21:241–247 Journal of Indian College of Cardiology 2015 5, S33-S37DOI: (10.1016/j.jicc.2015.03.020) Copyright © 2015 Terms and Conditions

Fig. 4 Aldosterone levels and risk of OSA in resistant hypertensive patients. Source: Calhoun DA, et al. Chest. 2004 Jan;125:112–117 Journal of Indian College of Cardiology 2015 5, S33-S37DOI: (10.1016/j.jicc.2015.03.020) Copyright © 2015 Terms and Conditions

Fig. 5 (a) AHI and HI correlation with plasma aldosterone levels in resistant hypertension patients (AHI: rho = 0.44, p=0.0002; HI: rho = 0.38, p=0.001). (b)AHI and HI correlation with plasma aldosterone levels in normal patients (AHI: rho = 0.12, p=0.52; HI: rho = 0.002, p=0.99). Source: Pratt-Ubunama MN,et al. Chest. 2007 Feb;131:453–459 Journal of Indian College of Cardiology 2015 5, S33-S37DOI: (10.1016/j.jicc.2015.03.020) Copyright © 2015 Terms and Conditions

Fig. 6 Effect of spironolactone on AHI in patients with resistant hypertension and moderate-severe OSA. Journal of Indian College of Cardiology 2015 5, S33-S37DOI: (10.1016/j.jicc.2015.03.020) Copyright © 2015 Terms and Conditions