Lui MM, et al. - In patients with difficult-to-control hypertension, researchers studied the association between obstructive sleep apnea (OSA), blood pressure (BP) control, and myocardial injury. For this investigation, they prospectively recruited hypertension patients who needed three or more medications at a tertiary referral center. Significant determinants of high-sensitivity troponin I (hsTnI) level were age, oxygen desaturation index (ODI), and loss of nocturnal systolic BP dip. Age, female sex, 24-hour mean diastolic BP, and metabolic syndrome were predictors of B-type natriuretic peptide (BNP) levels, but not indices of apnea severity. In patients with difficult-to-control hypertension, unrecognized severe OSA was common and OSA severity was related to myocardial injury, independent of BP control with medications.