TY - JOUR T1 - Con: continuous positive airway pressure and cardiovascular prevention JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02721-2017 VL - 51 IS - 5 SP - 1702721 AU - R. Doug McEvoy AU - Malcolm Kohler Y1 - 2018/05/01 UR - http://erj.ersjournals.com/content/51/5/1702721.abstract N2 - For the last two decades, evidence has been mounting that obstructive sleep apnoea (OSA) may be a cause of cardiovascular disease (CVD). OSA causes repeated acute falls in nocturnal arterial blood oxygen saturation, and rises in blood pressure and heart rate. These physiological changes, combined with the acute mechanical stress placed on the heart from the often very large negative pleural pressure swings during obstructed breathing, were postulated to provide the substrate necessary to induce acute events such as myocardial infarction, arrhythmias, acute heart failure, stroke and sudden cardiovascular death. Observational and case–control studies suggested that OSA is independently associated with daytime increases in some well-accepted markers of long-term cardiovascular risk such as hypertension [1, 2] and diabetes [3, 4], and other likely, yet clinically less well-accepted, markers such as endothelial dysfunction, lipid peroxidation (a marker of oxidative stress [5]) and insulin resistance. Also, community and sleep clinic cohort studies reported an association between OSA and adverse cardiovascular outcomes [6–9] that appeared to be independent of other well-known cardiovascular risk factors such as obesity, smoking, hypertension and diabetes. Furthermore, continuous positive airway pressure (CPAP) treatment studies lasting from a few weeks to several months found a reduction in blood pressure [10], and improvements in endothelial function [11] and insulin sensitivity [12]. Results of studies in animal models designed to mimic the conditions of OSA have tended to support these findings in humans [13, 14].Evidence does not support the use of CPAP treatment to reduce cardiovascular morbidity and mortality http://ow.ly/PgEp30jDipB ER -