The Sixth Report of the US Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) recently appeared,1 and the authors should be congratulated for clarifying such a complex subject for the physicians who treat hypertension. However, as in the previous report,2 the committee has again relegated to the sidelines obstructive sleep apnea (OSA) as a common contributing factor to essential hypertension (EH) or secondary hypertension. Despite the fact that OSA is present in 30% to 80% of all cases of EH3,4 and is considered in JNC VI to be a cause of resistant hypertension,1 the authors still do not consider it to be a contributing factor to EH or a major cause of secondary hypertension. They certainly do not mention OSA in either the section on EH or the section on common secondary causes of EH. In contrast, for example, they consider a diet lacking in carrots and other vegetables and apricots and other fruits to be a significant cause of EH.
Silverberg D, Oksenberg A, Iaina A. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and Obstructive Sleep Apnea: Let Their Silence Not Be Matched by the Silence of the Ordinary Physician. Arch Intern Med. 1998;158(11):1272-1273. doi: