阻塞性睡眠呼吸暂停（obstructive sleep apnea，OSA）相关高血压是一种由于睡眠过程中反复出现上气道阻塞，引起呼吸暂停、低通气和（或）呼吸努力相关微觉醒为特征，产生慢性间歇性缺氧、二氧化碳潴留、交感神经活动、睡眠碎片化等，进而导致慢性缺氧和血压增高为特征的一组复杂的涉及全身多系统损害的临床综合征。其典型表现为难治性高血压，夜间高血压及晨起血压升高，呈现非杓型或反杓型血压节律。OSA相关高血压按病理生理表型可分为低氧负担型、高觉醒型、高环路增益型、上气道塌陷型、高醛固酮型、混合型及其他类型。目前，OSA相关高血压的临床管理和治疗目标制定过度依赖睡眠呼吸暂停低通气指数（apnea hypopnea index，AHI），临床存在患者异质性与病理生理分型不足、共病与混杂因素考虑不足，以及持续气道正压通气（continuous positive airway pressure，CPAP）治疗依从性差和有效治疗剂量不足等问题，给疾病诊治和患者管理带来新的挑战。另外，OSA相关高血压常与肥胖、肿瘤、原发性醛固酮增多症、代谢综合征、胰岛素抵抗、慢性肾脏病等共存，尤其是老年患者。因此，基于精确的异质性和病理生理分型，OSA相关高血压诊治需采用以AHI和低氧负担为核心的多维度评估和治疗策略，结合生活方式干预、有效降低低氧负担、减重与睡眠管理、药物治疗、CPAP治疗、经皮导管射频去肾交感神经术、外科手术、器械治疗，以及人工智能等技术创新、政策支持、医保政策，在患者共同参与下，构建全生命周期管理与治疗新的体系。

Obstructive sleep apnea (OSA)-related hypertension is a complex clinical syndrome involving multisystem damage throughout the body. It is characterized by repeated upper airway obstruction during sleep, leading to apnea, hypopnea, and/or respiratory effort-related microarousals. These events result in chronic intermittent hypoxia, carbon dioxide retention, sympathetic nervous system activation, sleep fragmentation, which in turn contribute to chronic hypoxia and elevated blood pressure. The typical manifestations are refractory hypertension, nocturnal hypertension, and elevated morning blood pressure, presenting a non-dipper or reverse-dipper blood pressure rhythm. OSA-related hypertension can be classified into hypoxic burden type, high-arousal type, high-loop-gain type, upper airway collapse type, high-aldosterone type, mixed type, and other types. Currently, clinical management and treatment goal setting of OSA-related hypertension overly rely on the apnea-hypopnea index (AHI). In clinical practice, there are issues including insufficient consideration of patient heterogeneity and pathophysiological classification, inadequate consideration of comorbidities and confounding factors, poor adherence to continuous positive airway pressure (CPAP), and insufficient effective therapeutic dosage, all of which pose new challenges to disease diagnosis, treatment, and patient management. In addition, OSA-related hypertension often coexists with obesity, tumors, primary aldosteronism, metabolic syndrome, insulin resistance, chronic kidney disease, and other conditions, particularly in elderly patients. Therefore, based on precise heterogeneity and pathophysiological classification, a multidimensional assessment and treatment strategy for OSA-related hypertension centered on AHI and hypoxic burden—combined with lifestyle interventions, effective hypoxic burden reduction, weight loss and sleep management, pharmacotherapy, CPAP therapy, catheter-based renal denervation, surgical intervention, device therapy, technological innovations such as artificial intelligence, policy support, health insurance policies, and patient engagement—should be adopted to establish a new lifelong management and treatment system.