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Volume 139, Issue 1, Pages 7-16 (18 February 2010)


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Obstructive sleep apnea and cardiovascular disease

Mehmood Butta, Girish Dwivedia, Omer Khairb, Gregory Y.H. LipaCorresponding Author Informationemail address

Received 14 March 2009; received in revised form 7 May 2009; accepted 11 May 2009. published online 09 June 2009.

Abstract 

Obstructive sleep apnea (OSA) is a common yet an under-diagnosed sleep related breathing disorder affecting predominantly middle-aged men. OSA is associated with many adverse health outcomes, including cardiovascular disease. Common OSA associated/induced cardiovascular disorders include coronary artery disease, heart failure, hypertension, cardiac arrhythmias and stroke, which further increase morbidity and mortality in the OSA population. Endothelial dysfunction, coagulopathy, impaired sympathetic drive, oxidative and inflammatory stress are the pathophysiological pathways suggested for the development of cardiovascular disease in OSA.

The evidence would suggest that OSA should be considered as a cardiovascular risk factor, and is a treatable condition. Multiple studies using Continuous Positive Airway Pressure (CPAP) have shown improvements in the clinical state as well as retardation of disease progression. Therefore, patients with cardiovascular disease should be proactively screened for OSA and vice versa.

a University Department of Medicine, City Hospital, Birmingham B18 7QH, UK

b Department of Respiratory Medicine, City Hospital Birmingham B18 7QH, UK

Corresponding Author InformationCorresponding author. Tel.: +44 121 507 5080; fax: +44 121 507 5907.

PII: S0167-5273(09)00563-4

doi:10.1016/j.ijcard.2009.05.021


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