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Sex Differences in Atherosclerotic Cardiovascular Disease Risk in Obstructive Sleep Apnea.
Joshua M Bock1, Vinyas Shraffi Venkatesh2, Virend K Somers2
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, 55901, USA. bock.joshua@mayo.edu.
Current Atherosclerosis Reports
|June 11, 2025
Summary
Obstructive sleep apnea (OSA) increases atherosclerotic cardiovascular disease (ASCVD) risk, particularly in females. Emerging research suggests sex-specific differences in OSA
Area of Science:
- Cardiovascular Medicine
- Sleep Medicine
- Endocrinology
Background:
- Obstructive sleep apnea (OSA) is a prevalent condition linked to increased cardiovascular risk.
- Atherosclerotic cardiovascular disease (ASCVD) encompasses conditions like heart attack and stroke.
- Emerging evidence suggests potential sex-based disparities in OSA's impact on ASCVD.
Purpose of the Study:
- To review the association between obstructive sleep apnea (OSA) and atherosclerotic cardiovascular disease (ASCVD) risk.
- To highlight emerging data indicating potential sex differences in OSA-associated ASCVD risk.
Main Methods:
- Literature review of existing studies on OSA and ASCVD.
- Analysis of data focusing on sex-specific outcomes and risk factors.
- Exploration of potential underlying pathophysiological mechanisms.
Main Results:
- Females with OSA exhibit higher risks of hypertension, increased carotid intima-media thickness, and elevated cardiac enzymes compared to males with OSA.
- Females with OSA experience worse outcomes after ischemic cardiovascular events.
- Sex differences in nocturnal hypoxemia, immune responses, inflammation, and endothelial function, often linked to estrogen levels, may underlie these disparities.
Conclusions:
- OSA-associated ASCVD risk appears more pronounced in females, potentially due to sex-specific OSA etiology and pathophysiological pathways.
- Further research is needed to establish causality and develop individualized therapies for mitigating ASCVD in OSA patients.
- Understanding sex differences is crucial for targeted prevention and treatment strategies.
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