REVIEW ARTICLE
Obstructive sleep apnea and cardiovascular disease
J. o-Dee L. Lattimore, MBChB, FRACP* ,*,
David S. Celermajer, MBBS, MSc, PhD, FRACP* and
Ian Wilcox, BMedSci, MBBS, PhD, FRACP, FCCP*
* 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.
|
Abbreviations and Acronyms
| | AHI | = apnea-hypopnea index | | BMI | = body mass index | | CI | = confidence interval | | CPAP | = continuous positive airway pressure | | CSA | = central sleep apnea | | OR | = odds ratio | | OSA | = obstructive sleep apnea | | PHT | = pulmonary hypertension | | RR | = relative risk |
|
This article has been cited by other articles:
|
|
|
|
 
C. Matsumoto, T. Hayashi, K. Kitada, C. Yamashita, M. Miyamura, T. Mori, A. Ukimura, M. Ohkita, D. Jin, S. Takai, et al.
Chymase Plays an Important Role in Left Ventricular Remodeling Induced by Intermittent Hypoxia in Mice
Hypertension,
July 1, 2009;
54(1):
164 - 171.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Bailes, M. Baltzan, D. Rizzo, C. S Fichten, R. Grad, N. Wolkove, L. Creti, R. Amsel, and E. Libman
Sleep disorder symptoms are common and unspoken in Canadian general practice
Fam. Pract.,
June 2, 2009;
(2009)
cmp031v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Bitter, L. Faber, D. Hering, C. Langer, D. Horstkotte, and O. Oldenburg
Sleep-disordered breathing in heart failure with normal left ventricular ejection fraction
Eur J Heart Fail,
June 1, 2009;
11(6):
602 - 608.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. A. Waller, R. E. Bendel, and J. Kaplan
Sleep Disorders and the Eye
Mayo Clin. Proc.,
November 1, 2008;
83(11):
1251 - 1261.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
Circulation,
September 2, 2008;
118(10):
1080 - 1111.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
J. Am. Coll. Cardiol.,
August 19, 2008;
52(8):
686 - 717.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Hayashi, C. Yamashita, C. Matsumoto, C.-J. Kwak, K. Fujii, T. Hirata, M. Miyamura, T. Mori, A. Ukimura, Y. Okada, et al.
Role of gp91phox-containing NADPH oxidase in left ventricular remodeling induced by intermittent hypoxic stress
Am J Physiol Heart Circ Physiol,
May 1, 2008;
294(5):
H2197 - H2203.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Nakagawa, K. Kishida, S. Kihara, M. Sonoda, A. Hirata, A. Yasui, H. Nishizawa, T. Nakamura, R. Yoshida, I. Shimomura, et al.
Nocturnal reduction in circulating adiponectin concentrations related to hypoxic stress in severe obstructive sleep apnea-hypopnea syndrome
Am J Physiol Endocrinol Metab,
April 1, 2008;
294(4):
E778 - E784.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Kiekens, Veva De Groot, T. Coeckelbergh, M.-J. Tassignon, P. van de Heyning, Wilfried De Backer, and J. Verbraecken
Continuous Positive Airway Pressure Therapy Is Associated with an Increase in Intraocular Pressure in Obstructive Sleep Apnea
Invest. Ophthalmol. Vis. Sci.,
March 1, 2008;
49(3):
934 - 940.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. B. Bucca, L. Brussino, A. Battisti, R. Mutani, G. Rolla, L. Mangiardi, and A. Cicolin
Diuretics in Obstructive Sleep Apnea With Diastolic Heart Failure
Chest,
August 1, 2007;
132(2):
440 - 446.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. R. Coughlin, L. Mawdsley, J. A. Mugarza, J. P. H. Wilding, and P. M. A. Calverley
Cardiovascular and metabolic effects of CPAP in obese males with OSA
Eur. Respir. J.,
April 1, 2007;
29(4):
720 - 727.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Okuda, T. Ito, N. Emura, M. Suwa, T. Hayashi, H. Yoneda, and Y. Kitaura
Depressed Myocardial Contractile Reserve in Patients With Obstructive Sleep Apnea Assessed by Tissue Doppler Imaging With Dobutamine Stress Echocardiography
Chest,
April 1, 2007;
131(4):
1082 - 1089.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Zeng, A. T. Ng, M. A. Darendeliler, P. Petocz, and P. A. Cistulli
Use of Flow-Volume Curves to Predict Oral Appliance Treatment Outcome in Obstructive Sleep Apnea
Am. J. Respir. Crit. Care Med.,
April 1, 2007;
175(7):
726 - 730.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al.
ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death)
J. Am. Coll. Cardiol.,
September 5, 2006;
48(5):
1064 - 1108.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al.
ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death)
J. Am. Coll. Cardiol.,
September 5, 2006;
48(5):
e247 - e346.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. P. Zipes, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al.
ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death--executive summary: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.
Eur. Heart J.,
September 1, 2006;
27(17):
2099 - 2140.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Writing Committee Members, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al.
ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society
Europace,
September 1, 2006;
8(9):
746 - 837.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J L Lattimore, I Wilcox, M Skilton, M Langenfeld, and D S Celermajer
Treatment of obstructive sleep apnoea leads to improved microvascular endothelial function in the systemic circulation
Thorax,
June 1, 2006;
61(6):
491 - 495.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. M. Carney, W. B. Howells, K. E. Freedland, S. P. Duntley, P. K. Stein, M. W. Rich, and G. E. Miller
Depression and Obstructive Sleep Apnea in Patients With Coronary Heart Disease
Psychosom Med,
May 1, 2006;
68(3):
443 - 448.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Ferreira, J. Winck, P. Bettencourt, and F. Rocha-Goncalves
Heart failure and sleep apnoea: To sleep perchance to dream
Eur J Heart Fail,
May 1, 2006;
8(3):
227 - 236.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Shivalkar, C. Van De Heyning, M. Kerremans, D. Rinkevich, J. Verbraecken, W. De Backer, and C. Vrints
Obstructive Sleep Apnea Syndrome: More Insights on Structural and Functional Cardiac Alterations, and the Effects of Treatment With Continuous Positive Airway Pressure
J. Am. Coll. Cardiol.,
April 4, 2006;
47(7):
1433 - 1439.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Hashimoto, T. Ono, E.-i. Honda, K. Maeda, H. Shinagawa, S. Tsuiki, S. Hiyama, T. Kurabayashi, and K. Ohyama
Effects of mandibular advancement on brain activation during inspiratory loading in healthy subjects: a functional magnetic resonance imaging study
J Appl Physiol,
February 1, 2006;
100(2):
579 - 586.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-P. Baguet, L. Hammer, P. Levy, H. Pierre, S. Launois, J.-M. Mallion, and J.-L. Pepin
The Severity of Oxygen Desaturation Is Predictive of Carotid Wall Thickening and Plaque Occurrence
Chest,
November 1, 2005;
128(5):
3407 - 3412.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Dursunoglu, N. Dursunoglu, H. Evrengul, S. Ozkurt, O. Kuru, M. Kilic, and F. Fisekci
Impact of obstructive sleep apnoea on left ventricular mass and global function
Eur. Respir. J.,
August 1, 2005;
26(2):
283 - 288.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Luthje, C. Unterberg-Buchwald, D. Dajani, D. Vollmann, G. Hasenfuss, and S. Andreas
Atrial Overdrive Pacing in Patients with Sleep Apnea with Implanted Pacemaker
Am. J. Respir. Crit. Care Med.,
July 1, 2005;
172(1):
118 - 122.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Skobel, C. Norra, A. Sinha, C. Breuer, P. Hanrath, and C. Stellbrink
Impact of sleep-related breathing disorders on health-related quality of life in patients with chronic heart failure
Eur J Heart Fail,
June 1, 2005;
7(4):
505 - 511.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M.I. Polkey, R. Farre, and A.T. Dinh-Xuan
Respiratory monitoring: revisiting classical physiological principles with new tools
Eur. Respir. J.,
November 1, 2004;
24(5):
718 - 719.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. M. Shamsuzzaman, B. J. Gersh, and V. K. Somers
Mechanisms and Treatment of Obstructive Sleep Apnea--Reply
JAMA,
February 4, 2004;
291(5):
557 - 558.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Ohno, Y. Saito, N. Hanioka, H. Jinno, M. Saeki, M. Ando, S. Ozawa, and J.-i. Sawada
INVOLVEMENT OF HUMAN HEPATIC UGT1A1, UGT2B4, AND UGT2B7 IN THE GLUCURONIDATION OF CARVEDILOL
Drug Metab. Dispos.,
February 1, 2004;
32(2):
235 - 239.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
