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Obstructive sleep apnea and cardiovascular disease.
James M Parish1, Virend K Somers
1Sleep Disorders Center and Division of Pulmonary Medicine and Internal Medicine, Mayo Clinic College of Medicine, Scottsdale, Ariz 85259, USA.
Mayo Clinic Proceedings
|August 11, 2004
Summary
Obstructive sleep apnea (OSA) is a common condition linked to cardiovascular issues like hypertension and heart disease. Early awareness and management of OSA are crucial for preventing serious health complications.
Area of Science:
- Cardiology
- Sleep Medicine
- Pulmonology
Background:
- Obstructive sleep apnea (OSA) affects 5-15% of the population, causing airway obstruction during sleep.
- OSA is characterized by repetitive pharyngeal occlusions, leading to desaturation and arousal.
- It is linked to daytime sleepiness and fatigue due to fragmented sleep.
Purpose of the Study:
- To review the association between obstructive sleep apnea and cardiovascular disease.
- To highlight OSA as a risk factor for hypertension, stroke, and other cardiac conditions.
- To discuss the underlying pathophysiological mechanisms linking OSA and cardiovascular disease.
Main Methods:
- Literature review of studies investigating OSA and cardiovascular outcomes.
- Analysis of pathophysiological pathways including inflammation, autonomic dysfunction, and endothelial dysfunction.
- Examination of shared risk factors and biomarkers between OSA and atherosclerosis.
Main Results:
- OSA is a significant risk factor for hypertension, stroke, coronary heart disease, heart failure, and arrhythmias.
- Patients with OSA exhibit increased sympathetic activity, autonomic dysfunction, and pro-inflammatory/pro-thrombotic factors.
- Shared mechanisms with atherosclerosis include endothelial dysfunction, elevated C-reactive protein, interleukin-6, and fibrinogen.
Conclusions:
- OSA is strongly associated with an increased incidence of cardiovascular disease.
- Understanding the link between OSA and cardiovascular disease is critical for clinical practice.
- OSA may be an independent risk factor for cardiovascular morbidity and mortality.