Prevention of Parkinson's disease-related sudden death

Fulvio A Scorza,Antonio Carlos G De Almeida,Carla A Scorza,Josef Finsterer

doi:10.6061/clinics/2021/e3266

Abstract

The year 2021 marks 204 years since James Parkinson published his booklet entitled, “An Essay on the Shaking Palsy,” containing the first clear clinical description of the shaking palsy or paralysis agitans, now referred to as Parkinson’s disease (PD). However, he was unable to foresee the current illuminating period in PD research (- ). PD is the second most frequent neurodegenerative disorder of aging after Alzheimer’s disease and the most frequent movement disorder (- ). In most textbooks, PD is [...]

Highlights

Obstructive sleep apnea (OSA) is characterized by recurrent episodes of upper airway obstruction during sleep leading to acute primary responses that are potentially harmful to the cardiovascular system, including excessive negative intrathoracic pressure due to futile effort to breath, sleep fragmentation, and intermittent hypoxia (1)
A body of evidence shows that the primary effects elicited by OSA during sleep trigger a cascade of intermediate responses, such as increased sympathetic activity during sleep but throughout the 24-hr period, that contributes to high blood pressure (BP) (5)
Exclusion Criteria Age 465 years old Body Mass Index X40 kg/m2 Heart failure, previous acute myocardial infarction and previous stroke left ventricular ejection fraction (LVEF) o45% determined by echocardiography Moderate or severe valvar disease Systolic BP 4180 mmHg or diastolic BP 4110 mmHg Secondary causes of HTN other than OSA Chronic renal failure with serum creatinine X2 mg / dL Pregnancy Cocaine, alcohol, amphetamines, and other illicit drug users Sympathomimetics use, oral contraceptives, and nonsteroidal anti-inflammatory drugs

Summary

Introduction

Obstructive sleep apnea (OSA) is characterized by recurrent episodes of upper airway obstruction during sleep leading to acute primary responses that are potentially harmful to the cardiovascular system, including excessive negative intrathoracic pressure due to futile effort to breath, sleep fragmentation, and intermittent hypoxia (1). OSA can contribute to increase the risk of developing HTN (6), contribute to poor BP control, and to blood vessel and heart remodeling (7)

Objectives

Methods

Discussion

Conclusion