The Link Between Obstructive Sleep Apnea and Cardiovascular Disease
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Obstructive sleep apnea (OSA) is common in the general population and highly prevalent in patients with cardiovascular disease. In this paper, we review (1) the pathophysiological mechanisms of OSA that may causally contribute to cardiovascular disease; (2) current evidence regarding the association between OSA and hypertension, stroke, ischemic heart disease, heart failure, atrial fibrillation, and cardiovascular mortality; and (3) the impact of continuous positive airway pressure (CPAP) treatment on cardiovascular risk factors and outcomes. We emphasize the importance of obesity as a comorbidity of OSA and a confounder in the association between OSA and cardiovascular disease. We also discuss the importance of addressing obesity in patients with OSA, as a strategy to reduce the burden of cardiovascular risk factors in this population. Implications for the approach of patients’ OSA in clinical practice and future research directions are discussed.
KeywordsObstructive sleep apnea Cardiovascular disease Continuous positive airway pressure Hypertension Obesity Inflammation
Compliance with Ethical Standards
Conflict of Interest
Fré Bauters, Ernst R. Rietzschel, and Katrien B.C. Hertegonne declare that they have no conflict of interest.
Julio A. Chirinos declares personal consulting fees from Brystol Myers Squibb, OPKO Healthcare, Fukuda Denshi, and Merck; grants from National Institutes of Health, American College of Radiology Network, and Fukuda Denshi; and a device loan from Atcor Medical and declares a patent pending with U. of Penn for the use of inorganic nitrates/nitrites for the treatment of HFpEF.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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