Obstructive sleep apnea, hypertension and cardiovascular diseases

Area of Science:

• Cardiology
• Pulmonology
• Sleep Medicine

Background:

• Obstructive sleep apnea (OSA) involves repeated breathing interruptions during sleep due to pharyngeal airway collapse.
• OSA is increasingly recognized for its significant cardiovascular implications.

Purpose of the Study:

• To review the established and potential cardiovascular consequences of OSA.
• To highlight the role of OSA in conditions such as hypertension, coronary artery disease, and heart failure.
• To emphasize the need for further research on OSA's impact on dyslipidemia, type 2 diabetes, and cardiovascular mortality, and the benefits of continuous positive airway pressure (CPAP) therapy.

Main Methods:

• Review of observational and prospective studies examining the relationship between OSA and cardiovascular diseases.
• Analysis of pathophysiological mechanisms linking OSA to cardiovascular changes.
• Assessment of OSA prevalence in specific populations, including hypertensive and obese individuals.

Main Results:

• Strong evidence confirms a positive association between OSA and hypertension, coronary artery disease, atrial fibrillation, stroke, and heart failure.
• Key pathophysiological mechanisms include intermittent hypoxemia, re-oxygenation, sleep arousals, and intrathoracic pressure variations.
• Hypertension is linked to OSA via sympathetic nervous system activation, renin-angiotensin-aldosterone system stimulation, and impaired endothelial function.

Conclusions:

• OSA is highly prevalent in the general population, hypertensive patients, and obese individuals.
• Effective screening, diagnosis, and treatment of OSA are essential for reducing cardiovascular risk.
• Further investigation is warranted to fully understand OSA's impact on metabolic disorders and its influence on cardiovascular mortality, as well as the benefits of CPAP treatment.