|
 |
|
|||||||
|
|||||||||
Copyright ©ERS Journals Ltd 2007
Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities
1 Respiratory Sleep Disorders Unit, St Vincent’s University Hospital, Dublin, Ireland. 2 Dept of Medicine, Pneumology, Physiology and Nutrition (DIMPEFINU), University of Palermo, Palermo, Italy.
CORRESPONDENCE: W. T. McNicholas, Respiratory Sleep Disorders Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Fax: 353 12697949. E-mail: walter.mcnicholas{at}ucd.ie
Keywords: Cardiovascular disease, intermittent hypoxia, mechanisms, obstructive sleep apnoea
Received: February 23, 2006
Accepted August 28, 2006
Considerable evidence is available in support of an independent association between obstructive sleep apnoea syndrome (OSAS) and cardiovascular disease, which is particularly strong for systemic arterial hypertension and growing for ischaemic heart disease, stroke, heart failure, atrial fibrillation and cardiac sudden death.
The pathogenesis of cardiovascular disease in OSAS is not completely understood but likely to be multifactorial, involving a diverse range of mechanisms including sympathetic nervous system overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism.
The present report, which arose out of a European Union Cooperation in the field of Scientific and Technical Research (COST) action on OSAS (COST B26), reviews the current evidence for an independent association and proposes research priorities to identify the underlying mechanisms involved, with a view to identifying novel therapeutic strategies.
Large-scale collaborative studies of carefully defined patient populations with obstructive sleep apnoea syndrome, adequately controlled for potential confounders, are needed. Such studies carry the prospect of evaluating potential interactions between different basic mechanisms operating in obstructive sleep apnoea syndrome and cardiovascular disease, and interactions with other related disorders, such as obesity, diabetes and dyslipidaemia. Furthermore, translational studies involving cell culture and animal models linked to studies of obstructive sleep apnoea syndrome patients are necessary to integrate basic mechanisms with the clinical disorder.
This article has been cited by other articles:
|
|
 |
|
  P. Levy, M. R. Bonsignore, and J. Eckel Sleep, sleep-disordered breathing and metabolic consequences Eur. Respir. J., July 1, 2009; 34(1): 243 - 260. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Ryan, C T Taylor, and W T McNicholas Systemic inflammation: a key factor in the pathogenesis of cardiovascular complications in obstructive sleep apnoea syndrome? Thorax, July 1, 2009; 64(7): 631 - 636. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Enoz and H. M. Inancli CPAP and measures of cardiovascular risks in patients with OSAS Eur. Respir. J., June 1, 2009; 33(6): 1520 - 1520. [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Bonsignore and J. Eckel Metabolic aspects of obstructive sleep apnoea syndrome Eur. Respir. Rev., June 1, 2009; 18(112): 113 - 124. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Garvey, C. T. Taylor, and W. T. McNicholas Cardiovascular disease in obstructive sleep apnoea syndrome: the role of intermittent hypoxia and inflammation Eur. Respir. J., May 1, 2009; 33(5): 1195 - 1205. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Belaidi, M. Joyeux-Faure, C. Ribuot, S. H. Launois, P. Levy, and D. Godin-Ribuot Major role for hypoxia inducible factor-1 and the endothelin system in promoting myocardial infarction and hypertension in an animal model of obstructive sleep apnea. J. Am. Coll. Cardiol., April 14, 2009; 53(15): 1309 - 1317. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Jennum and R. L. Riha Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing Eur. Respir. J., April 1, 2009; 33(4): 907 - 914. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Riha and W. T. McNicholas The genetic and cardiovascular aspects of obstructive sleep apnoea/hypopnoea syndrome Eur. Respir. J., February 1, 2009; 33(2): 233 - 236. [Full Text] [PDF]
|
|
|
|
 |
|
 R. N. Khayat, W. T. Abraham, B. Patt, M. Roy, K. Hua, and D. Jarjoura Cardiac Effects of Continuous and Bilevel Positive Airway Pressure for Patients With Heart Failure and Obstructive Sleep Apnea: A Pilot Study Chest, December 1, 2008; 134(6): 1162 - 1168. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Nakano, T. Tanigawa, Y. Ohnishi, H. Uemori, K. Senzaki, T. Furukawa, and S. Nishima Validation of a single-channel airflow monitor for screening of sleep-disordered breathing Eur. Respir. J., October 1, 2008; 32(4): 1060 - 1067. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) Circulation, September 2, 2008; 118(10): 1080 - 1111. [Full Text] [PDF]
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717. [Full Text] [PDF]
|
|
|
|
|
|
S. Andreas and G. Eichele Sleep apnoea: time to consider clock genes Eur. Respir. J., July 1, 2008; 32(1): 1 - 2. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Aittokallio, O. Polo, J. Hiissa, A. Virkki, J. Toikka, O. Raitakari, T. Saaresranta, and T. Aittokallio Overnight variability in transcutaneous carbon dioxide predicts vascular impairment in women Exp Physiol, July 1, 2008; 93(7): 880 - 891. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Eckert and A. Malhotra Pathophysiology of Adult Obstructive Sleep Apnea Proceedings of the ATS, February 15, 2008; 5(2): 144 - 153. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. T. McNicholas Diagnosis of Obstructive Sleep Apnea in Adults Proceedings of the ATS, February 15, 2008; 5(2): 154 - 160. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Tasali and M. S. M. Ip Obstructive Sleep Apnea and Metabolic Syndrome: Alterations in Glucose Metabolism and Inflammation Proceedings of the ATS, February 15, 2008; 5(2): 207 - 217. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hanaoka, X. Yu, K. Urushihata, M. Ota, K. Fujimoto, and K. Kubo Leptin and Leptin Receptor Gene Polymorphisms in Obstructive Sleep Apnea Syndrome Chest, January 1, 2008; 133(1): 79 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Amit Benjamin and K E Lewis Sleep-disordered breathing and cardiovascular disease Postgrad. Med. J., January 1, 2008; 84(987): 15 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Lavie Mortality in sleep apnoea syndrome: a review of the evidence Eur. Respir. Rev., December 1, 2007; 16(106): 203 - 210. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. T. McNicholas Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1666 - R1670. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. F. Drager, E. M. Krieger, and G. Lorenzi-Filho Sympathetic Activity, Heart Failure, Obesity, and Metabolic Syndrome: Is There Any Role for Obstructive Sleep Apnea? Hypertension, June 1, 2007; 49(6): e38 - e38. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |