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J Am Coll Cardiol, 2003; 41:1429-1437, doi:10.1016/S0735-1097(03)00184-0 © 2003 by the American College of Cardiology Foundation |
,*
* Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
Department of Medicine, University of Sydney, Sydney, Australia
Manuscript received February 27, 2002; revised manuscript received November 29, 2002, accepted December 16, 2002.
* Reprint requests and correspondence: Dr. Jo-Dee L. Lattimore, Department of Cardiology, Royal Prince Alfred Hospital, Missenden Road, Camperdown NSW 2050, Sydney, Australia.
jodee.lattimore{at}email.cs.nsw.gov.au
Obstructive sleep apnea (OSA) is a common disorder associated with an increased risk of cardiovascular disease and stroke. As it is strongly associated with known cardiovascular risk factors, including obesity, insulin resistance, and dyslipidemia, OSA is an independent risk factor for hypertension and has also been implicated in the pathogenesis of congestive cardiac failure, pulmonary hypertension, arrhythmias, and atherosclerosis. Obesity is strongly linked to an increased risk of OSA, and weight loss can reduce the severity of OSA. The current standard treatment for OSA—nasal continuous positive airway pressure (CPAP)—eliminates apnea and the ensuing acute hemodynamic changes during sleep. Long-term CPAP treatment studies have shown a reduction in nocturnal cardiac ischemic episodes and improvements in daytime blood pressure levels and left ventricular function. Despite the availability of effective therapy, OSA remains an underdiagnosed and undertreated condition. A lack of physician awareness is one of the primary reasons for this deficit in diagnosis and treatment.
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