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Cardiovascular consequences of obstructive sleep apnea
Najib T Ayas1, Carolyn M Taylor, Ismail Laher
1aDepartment of Medicine bMember of the Canadian Sleep and Circadian Network cDivision of Cardiology, St Paul's Hospital dDepartment of Pharmacology and Therapeutic, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Current Opinion in Cardiology
|September 23, 2016
Summary
Obstructive sleep apnea (OSA) is linked to cardiovascular diseases like hypertension and stroke. Positive airway pressure (PAP) therapy improves outcomes, but large trials are needed to confirm event reduction.
Area of Science:
- Cardiology
- Pulmonology
- Sleep Medicine
Background:
- Growing obesity epidemic fuels rising obstructive sleep apnea (OSA) diagnoses.
- OSA is increasingly recognized for its significant impact on cardiovascular diseases (CVDs).
Purpose of the Study:
- To review recent literature on the association between OSA and CVD.
- To examine the cardiovascular consequences and treatment of OSA.
Main Methods:
- Review of recent publications examining OSA and CVD links.
- Analysis of treatment modalities including positive airway pressure (PAP) and oral appliances.
Main Results:
- Cardiovascular consequences of OSA include hypertension, stroke, atrial fibrillation, and heart failure, linked to endothelial dysfunction, oxidative stress, and inflammation.
- PAP therapy shows modest blood pressure reduction and improved glucose control in some patients.
- Adherence to PAP therapy is crucial for better patient outcomes, though its role in preventing cardiovascular events requires further study.
Conclusions:
- Effective OSA management with PAP reduces mortality and morbidity.
- Large randomized trials are pending to definitively establish PAP's role in preventing cardiovascular events.
- Biomarker identification may enable personalized OSA treatment strategies.
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