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阻塞性睡眠呼吸暂停的心血管影响和持续的正气道压力治疗的影响:来自不同研究模型的证据
Matteo Bradicich1, Martino F Pengo2, Joerg Steier3
1Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
ERJ open research
|March 25, 2025
概括
阻塞性睡眠呼吸暂停 (OSA) 导致心血管问题,如高血压和主要不良心血管事件 (MACE). 持续的正气道压力 (CPAP) 疗法可以降低血压并降低MACE风险,尤其是在良好的坚持的情况下.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 公共卫生 公共卫生
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与显著的心血管后果有关.
- 持续正气道压力 (CPAP) 治疗是OSA的主要治疗方法.
- 几十年的研究探索了OSA对心血管的影响和CPAP的疗效,有时产生了相互矛盾的结果.
研究的目的:
- 综合有关OSA患者心血管结果的证据.
- 评估CPAP治疗对血压,内皮功能和MACE的影响.
- 讨论来自各种研究设计的证据水平.
主要方法:
- 在PubMed进行文献搜索,截至2023年9月.
- 包括随机对照试验,元分析,基于人口的研究和OSA队列研究.
- 专注于心血管终点:血压,动脉高血压,内皮功能和MACE.
主要成果:
- 高水平的证据证实了OSA与高血压和内皮功能障碍的因果关系.
- 未经治疗的OSA与特定患者亚组中更高的MACE发病率有关.
- CPAP的降血压效果在耐性高血压中最显著;MACE风险的降低取决于CPAP的坚持.
结论:
- 在OSA中,心血管风险受到严重程度,症状,表型和并发症的影响.
- 患有严重的OSA和低氧症的年轻患者可能特别受益于CPAP,以减少心血管风险.
- 需要进一步的随机对照试验来确定CPAP在初级心血管预防和高风险人群中的作用.
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