Cardiovascular effects of obstructive sleep apnoea and effects of continuous positive airway pressure therapy: evidence from different study models
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View abstract on PubMed
Summary
This summary is machine-generated.Obstructive sleep apnoea (OSA) causes cardiovascular issues like hypertension and major adverse cardiovascular events (MACE). Continuous positive airway pressure (CPAP) therapy can lower blood pressure and reduce MACE risk, especially with good adherence.
Area Of Science
- Cardiology
- Sleep Medicine
- Public Health
Background
- Obstructive sleep apnoea (OSA) is linked to significant cardiovascular consequences.
- Continuous positive airway pressure (CPAP) therapy is a primary treatment for OSA.
- Decades of research explored OSA's cardiovascular impact and CPAP's efficacy, yielding sometimes conflicting results.
Purpose Of The Study
- To synthesize evidence on cardiovascular outcomes in OSA patients.
- To evaluate the effects of CPAP therapy on blood pressure, endothelial function, and MACE.
- To discuss the level of evidence from various study designs.
Main Methods
- Conducted a literature search in PubMed up to September 2023.
- Included randomized controlled trials, meta-analyses, population-based studies, and OSA cohort studies.
- Focused on cardiovascular endpoints: blood pressure, arterial hypertension, endothelial function, and MACE.
Main Results
- High-level evidence confirms OSA's causal link to hypertension and endothelial dysfunction.
- Untreated OSA is associated with higher MACE incidence in specific patient subgroups.
- CPAP's blood pressure-lowering effect is most notable in resistant hypertension; MACE risk reduction hinges on CPAP adherence.
Conclusions
- Cardiovascular risks in OSA are influenced by severity, symptoms, phenotype, and comorbidities.
- Younger patients with severe OSA and hypoxemia may particularly benefit from CPAP for cardiovascular risk reduction.
- Further randomized controlled trials are needed for CPAP's role in primary cardiovascular prevention and high-risk populations.
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