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Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common chronic sleep disorder. As the incidence of OSAHS increases, it has seriously threatened people's health. It causes significant morbidity and mortality in both developed and developing countries around the world. However, clinical trials of OSAHS have heterogeneous outcomes, surrogate outcomes, subjective outcomes, composite outcomes, and a lack of endpoints or patient perspectives. The diagnosis is confirmed by a sleep study. The main treatment for OSAS is the use of continuous positive airway pressure (CPAP) at night via a nasal or oronasal mask, which usually results in rapid improvement of symptoms. Patients who cannot tolerate CPAP therapy can be successfully treated with a mandibular advancement device. Supportive measures include regular and sufficiently long sleep periods, refraining from smoking and alcohol consumption in the evening, and weight reduction in overweight patients. Keywords: Obstructive sleep apnea-hypopnea syndrome, continuous positive airway pressure, apnea-hypopnea index.

Resistant hypertension is defined as blood pressure above the patient’s goal despite the use of 3 or more antihypertensive agents from different classes at optimal doses, one of which should ideally be a diuretic .Evaluating patients with resistive hypertension should first confirm that they have genuine resistant hypertension through elimination or correction of pseude resistence factors such as white coat hypertension, suboptimal blood pressure measurement technique, poor medication compliance, inappropriate antihypertensive dosage or combinaison, and white coat effects and clinical inertia.Resistant hypertension therapy includes improved compliance with the use of drugs, secondary hypertension detection and treatment, use of lifestyle measures and treatment of obesity, and other comorbidities. switching to a long-acting diuretic type of thiazide like chlorthalidone could improve the BP from the patients taking hydrochlorothiazide. However, clinical trials of OSAHS have heterogeneous outcomes, surrogate outcomes, subjective outcomes, composite outcomes, and a lack of endpoints or patient perspectives. The diagnosis is confirmed by a sleep study. The main treatment for OSAS is the use of continuous positive airway pressure (CPAP) at night via a nasal or oronasal mask, which usually results in rapid improvement of symptoms. Patients who cannot tolerate CPAP therapy can be successfully treated with a mandibular advancement device. Supportive measures include regular and sufficiently long sleep periods, refraining from smoking and alcohol consumption in the evening, and weight reduction in overweight patients. Keywords: hypertension, resistant hypertension . obstructive sleep apnea. Title: Resistant Hypertension and Its Correlated Disease Author: Abass M. Ahmed, Abdirizak s Daror International Journal of Recent Research in Life Sciences (IJRRLS) ISSN 2349-7823 Vol. 9, Issue 3, July 2022 - September 2022 Page No: 14-18 Paper Publications Website: www.paperpublications.org Published Date: 16-August-2022 DOI: https://doi.org/10.5281/zenodo.6997949 Paper Download Link (Source) https://www.paperpublications.org/upload/book/Resistant%20Hypertension-16082022-4.pdf, International Journal of Recent Research in Life Sciences (IJRRLS), ISSN 2349-7823, Paper Publications, Website: www.paperpublications.org, {"references":["[1]\tGBD 2016 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet 390, 1345–1422 (2017).","[2]\tPersell, S. D. Prevalence of resistant hypertension in the United States, 2003–2008. 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Background. Peripheral arterial disease (PAD) is a typical disease of atherosclerosis, most commonly influencing the lower extremities. In patients with PAD, revascularization remains a preferred treatment strategy. Buyang Huanwu decoction (BHD) is a popular Chinese herbal prescription which has showed effects of cardiovascular protection through conducting antioxidant, antiapoptotic, and anti-inflammatory effects. Here, we intend to study the effect of BHD on promoting revascularization via the Akt/GSK3β/NRF2 pathway in diabetic hindlimb ischemia (HLI) model of mice. Materials and Methods. All db/db mice ( n = 60 ) were randomly divided into 6 groups by table of random number. (1) Sham group ( N = 10 ): 7-0 suture thread passed through the underneath of the femoral artery and vein without occlusion. The remaining 5 groups were treated differently on the basis of the HLI (the femoral artery and vein from the inguinal ligament to the knee joint were transected and the vascular stump was ligated with 7-0 silk sutures) model: (2) HLI+NS group ( N = 15 ): 0.2 ml NS was gavaged daily for 3 days before modeling and 14 days after occlusion; (3) HLI+BHD group ( N = 15 ): 0.2 ml BHD (20 g/kg/day) was gavaged daily for 3 days before modeling and 14 days after occlusion; (4) HLI+BHD+sh-NC group ( N = 8 ): local injection of adenovirus vector carrying the nonsense shRNA (Ad-GFP) in the hindlimbs of mice before treatment; (5) HLI+BHD+sh-NRF2 group ( N = 8 ): knockdown of NRF2 in the hindlimbs of mice by local intramuscular injection of adenovirus vector carrying NRF2 shRNA (Ad-NRF2-shRNA) before treatment; and (6) HLI+BHD+LY294002 group ( N = 4 ): intravenous injection of LY294002 (1.5 mg/kg) once a day for 14 days on the basis of the HLI+BHD group. Laser Doppler examination, vascular cast, and immunofluorescence staining were applied to detect the revascularization of lower limbs in mice. Western blot analysis was used to detect the expression of vascular endothelial growth factor (VEGF), interleukin-1beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor- (TNF-) α, heme oxygenase-1 (HO-1), NAD(P)H dehydrogenase quinone-1 (NQO-1), catalase (CAT), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), phosphorylated protein kinase B (p-AKT), and phosphorylated glycogen synthase kinase-3 beta (p-GSK3β). HE staining was used to assess the level of muscle tissue damage and inflammation in the lower extremities. Local multipoint injection of Ad-NRF2-shRNA was used to knock down NRF2, and qPCR was applied to detect the mRNA level of NRF2. The blood glucose, triglyceride, cholesterol, MDA, and SOD levels of mice were tested using corresponding kits. The SPSS 20.0 software and GraphPad Prism 6.05 were used to do all statistics. Values of P < 0.05 were considered as statistically significant. Results and Conclusions. BHD could enhance the revascularization of lower limbs in HLI mice, while BHD has no effect on blood glucose and lipid level in db/db mice ( P > 0.05 ). BHD could elevate the protein expression of VEGF, HO-1, NQO-1, and CAT ( P < 0.05 ) and decrease the expression of IL-1β, IL-6, and TNF-α ( P < 0.05 ) in HLI mice. Meanwhile, BHD could activate NRF2 and promote the phosphorylation of AKT/GSK3β during revascularization ( P < 0.05 ). In contrast, knockdown of NRF2 impaired the protective effects of BHD on HLI ( P < 0.05 ). LY294002 inhibited the upregulation of NRF2 activated by BHD through inhibiting the phosphorylation of the AKT/GSK3β pathway ( P < 0.05 ). The present study demonstrated that BHD could promote revascularization on db/db mice with HLI through targeting antioxidation, anti-inflammation, and angiogenesis via the AKT/GSK3β/NRF2 pathway.