OBSTRUCTIVE SLEEP APNEA AND CARDIOVASCULAR DISEASE: MECHANISMS, CLINICAL IMPLICATIONS, AND MANAGEMENT INSIGHTS
Keywords:
obstructive sleep apnea, cardiovascular disease, intermittent hypoxia, CPAP, hypertension, endothelial dysfunctionAbstract
This literature review explores the association between obstructive sleep apnea (OSA) and cardiovascular disease (CVD), highlighting mechanisms such as chronic intermittent hypoxia, oxidative stress, and endothelial dysfunction. The paper discusses clinical implications of OSA on hypertension, heart failure, arrhythmias, and stroke, and evaluates the impact of treatments such as CPAP and weight loss. Emphasis is placed on emerging strategies for diagnosis and personalized interventions to mitigate CVD risks in OSA patients.
References
Aslan, A. et al. (2020). CPAP and cardiovascular outcomes: A meta-analysis. Journal of Clinical Sleep Medicine, 16(7), 1111–1120.
McEvoy, R. D. et al. (2016). CPAP for prevention of cardiovascular events in obstructive sleep apnea. NEJM, 375(10), 919–931.
Iftikhar, I. H. et al. (2013). Effects of CPAP on cardiovascular outcomes. Chest, 143(4), 1070–1077.
Chen, X. et al. (2019). Impact of CPAP on carotid intima-media thickness in OSA: A meta-analysis. Sleep Medicine, 56, 163–170.
Barceló, A. et al. (2019). Inflammatory markers in OSA and response to CPAP. Respiratory Research, 20, 84.
Svatikova, A. et al. (2015). Irisin and metabolic parameters after CPAP. Journal of Sleep Research, 24(5), 515–521.
Bratton, D. J. et al. (2014). CPAP therapy and blood pressure: A meta-analysis. JAMA, 312(20), 2073–2083.
Pépin, J. L. et al. (2010). Adherence to CPAP and blood pressure outcomes. American Journal of Respiratory and Critical Care Medicine, 182(7), 958–965.
Gaddam, K. et al. (2010). Spironolactone in resistant hypertension with OSA. Hypertension, 57(3), 532–539.
Harsch, I. A. et al. (2018). CPAP and glycemic control in diabetes: A meta-analysis. Diabetes Care, 41(2), e22–e24.
Martínez-Ceron, E. et al. (2016). CPAP and metabolic control in type 2 diabetes. Diabetes Care, 39(3), 456–463.
Borel, A. L. et al. (2013). CPAP improves glucose variability in type 2 diabetes. Sleep Medicine, 14(1), 53–59.
Xie, C. et al. (2017). OSA and risk of cardiovascular events post-PCI. Heart, 103(21), 1706–1712.
Nakashima, H. et al. (2011). OSA and impaired reperfusion after STEMI. Sleep and Breathing, 15(3), 493–499.
Peker, Y. et al. (2016). CPAP treatment and cardiovascular events in CAD. Lancet Respir Med, 4(10), 804–813.
Brill, A. K. et al. (2018). Sleep apnea in stroke recovery: Clinical perspectives. Lancet Neurology, 17(9), 707–719.
Arzt, M. et al. (2021). Sleep-disordered breathing and stroke. European Respiratory Review, 30(160), 200221.
Lacedonia, D. et al. (2020). Pulmonary hypertension and OSA: An underestimated link. Sleep Medicine Reviews, 52, 101306.
Basyal, B. et al. (2022). Pulmonary hypertension in OSA: Treatment implications. Respiration, 101(5), 453–463.
Ashrafian, H. et al. (2021). Effect of bariatric surgery on OSA and metabolic syndrome. The Lancet Diabetes & Endocrinology, 9(8), 579–590.
Yeghiazarians, Y. et al. (2021). Obstructive sleep apnea and cardiovascular disease: A scientific statement. Circulation, 144(3), e56–e67.
Assallum, H., Song, T. Y., Aronow, W. S., Chandy, D. (2021). Obstructive sleep apnoea and cardiovascular disease: a literature review. Archives of Medical Science, 17(5), 1200-1212. https://doi.org/10.5114/aoms.2019.88558