Abstract
The results of prospective studies, meta-analyzes and systematic reviews on the associations of obstructive sleep apnea (OSA) with various cardiovascular diseases (CVD) were analyzed. Currently, the mechanisms related to high prevalence of breathing-related sleep disorders among population of economically developed countries are clear, and an increase in the number of OSA patients has been shown. The relationship between OSA and CVD has been widely confirmed in large cohort studies. The first review part discusses the relationship of hypertension (HTN) and various heart arrhythmias (atrial fibrillation (AF), bradyarrhythmias, premature ventricular contraction, sudden death during sleep) with breathing-related sleep disorders. These groups of cardiovascular disorders currently show the most proven relationship with sleep apnea. In addition to cross-sectional studies indicating the high prevalence of OSA in patients with HTN and AF, some observational studies indicate an increase in the number of patients with HTN and paroxysmal AF with history of untreated sleep apnea. An analysis of the current issues of OSA phenotypes (in particular, REM-related OSA in hypertensive patients) as the most unfavorable cardiovascular factors is carried out.
Highlights
The mechanisms related to high prevalence of breathing-related sleep disorders among population of economically developed countries are clear, and an increase in the number of obstructive sleep apnea (OSA) patients has been shown
The relationship between OSA and cardiovascular diseases (CVD) has been widely confirmed in large cohort studies
The first review part discusses the relationship of hypertension (HTN) and various heart arrhythmias (atrial fibrillation (AF), bradyarrhythmias, premature ventricular contraction, sudden death during sleep) with breathing-related sleep disorders
Summary
АГ, которая сама по себе является ССЗ, в то же время выступает в качестве одного из самых важных факторов риска (ФР) развития других форм ССЗ. В большинстве перекрестных исследований было показано, что риск развития АГ возрастает с увеличением степени тяжести ОАС. Висконсинское исследование показало линейную зависимость между АГ и тя жестью ОАС в когорте 1060 мужчин и женщин в возрасте 30-60 лет после коррекции на возраст, пол и индекс массы тела (ИМТ). Что в этой когорте в возрасте >60 лет никакой существенной связи между АГ и ОАС любой степени тяжести не наблюдалось [21]. Хотя в группе из 1741 взрослых ОШ развития АГ с нарастанием степени тяжести ОАС увеличивалось, сила этой ассоциация у более возрастных больных уменьшалась. Включавшее 2677 взрослых в возрасте 20-85 лет, также продемонстрировало линейную связь между АГ и степенью тяжести АС после поправки на возраст, ИМТ и пол. Что ИД в отличие от ИАГ оказался значимым предиктором АГ: ОШ для ИД — 2,01 (95% ДИ, 1,61-2,51); ОШ для ИАГ — 0,92 (95% ДИ, 0,74-1,15) [25]
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