Cardiovascular Implications of Intermittent Hypoxia: A Comprehensive Narrative Review.

Area of Science:

• Cardiovascular Science
• Sleep Medicine
• Molecular Biology

Background:

• Intermittent hypoxia (IH), prevalent in obstructive sleep apnea (OSA), presents a dual role in cardiovascular health, acting as both a disease risk factor and a potential therapeutic agent.
• The complex interplay between IH and cardiovascular pathologies necessitates a thorough understanding of underlying molecular pathways.

Purpose of the Study:

• To review the molecular mechanisms linking IH to cardiovascular diseases such as hypertension, heart failure, arrhythmias, and atherosclerosis.
• To evaluate current and emerging therapeutic strategies for managing IH-related cardiovascular complications.

Main Methods:

• Narrative review synthesizing clinical and experimental data.
• Exploration of molecular pathways including oxidative stress, sympathetic hyperactivity, and HIF-1α-mediated inflammation.
• Assessment of treatment modalities like CPAP, weight reduction, and pharmacotherapy.

Main Results:

• IH is strongly associated with increased cardiovascular morbidity and mortality, particularly in susceptible populations.
• Key molecular processes driven by IH contribute to vascular and myocardial remodeling.
• Various treatments show effectiveness, with personalized strategies and early screening being crucial.

Conclusions:

• IH exerts both detrimental and potentially beneficial effects on cardiovascular health, contingent on context and management.
• Further research into IH-based cardioprotection and biomarker discovery holds promise for future therapeutic advancements.
• Personalized treatment approaches are essential for optimizing patient outcomes in IH-related cardiovascular conditions.