Obstructive Sleep Apnea, Stroke, and Cardiovascular Diseases

被引:73
作者
Bagai, Kanika [1 ]
机构
[1] Vanderbilt Univ, Med Ctr, Dept Neurol, Nashville, TN 37232 USA
关键词
obstructive sleep apnea; endothelial dysfunction; intermittent hypoxia; arousals; treatment; POSITIVE AIRWAY PRESSURE; PLASMINOGEN-ACTIVATOR INHIBITOR-1; CORONARY-ARTERY-DISEASE; ACUTE ISCHEMIC-STROKE; C-REACTIVE PROTEIN; PRACTICE PARAMETERS; INTERMITTENT HYPOXIA; CIRCADIAN VARIATION; GENE-EXPRESSION; HEART-FAILURE;
D O I
10.1097/NRL.0b013e3181f097cb
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
Background: Obstructive sleep apnea (OSA) is gaining recognition as a cardiovascular and cerebrovascular risk factor. Sleep apnea is now implicated in the etiopathogenesis of stroke, coronary artery disease, hypertension, and congestive heart failure. Review Summary: OSA exerts its negative cardiovascular consequences through its unique pattern of intermittent hypoxia and arousals. The putative mechanisms involved in the pathogenesis of cardiovascular disease in USA include fibrinolytic imbalance, endothelial dysfunction, oxidative stress, and inflammation. This study discusses the known cellular and molecular processes that promote atherogenesis and vascular dysfunction in patients with USA, and their implications for cardiovascular disease and prevention in that patient population. Conclusion: Neurologists should familiarize themselves with the symptoms and signs of USA and the pathophysiology of the association between untreated USA and cardiovascular disease, including stroke. USA should be ruled out in patients with cardiovascular disease and be regarded as an important modifiable risk factor. Knowledge of this association is of prime public health importance and can result in primary and secondary prevention of cardiovascular events. This study will also help neurologists in providing patient education and treatment.
引用
收藏
页码:329 / 339
页数:11
相关论文
共 93 条
[1]
Snoring as a risk factor for type II diabetes mellitus: A prospective study [J].
Al-Delaimy, WK ;
Manson, JE ;
Willett, WC ;
Stampfer, MJ ;
Hu, FB .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2002, 155 (05) :387-393
[2]
CIRCADIAN VARIATION OF FIBRINOLYTIC-ACTIVITY IN BLOOD [J].
ANDREOTTI, F ;
KLUFT, C .
CHRONOBIOLOGY INTERNATIONAL, 1991, 8 (05) :336-351
[3]
Sleep apnea in acute cerebrovascular diseases: Final report on 128 patients [J].
Bassetti, C ;
Aldrich, MS .
SLEEP, 1999, 22 (02) :217-223
[4]
Sleep apnea in pat ischemic attack and stroke: A prospective study of 59 patients [J].
Bassetti, C ;
Aldrich, MS ;
Chervin, RD ;
Quint, D .
NEUROLOGY, 1996, 47 (05) :1167-1173
[5]
Sleep-disordered breathing and acute ischemic stroke - Diagnosis, risk factors, treatment, evolution, and long-term clinical outcome [J].
Bassetti, CL ;
Milanova, M ;
Gugger, M .
STROKE, 2006, 37 (04) :967-972
[6]
Obstructive sleep apnea as a cause of systemic hypertension - Evidence from a canine model [J].
Brooks, D ;
Horner, RL ;
Kozar, LF ;
RenderTeixeira, CL ;
Phillipson, EA .
JOURNAL OF CLINICAL INVESTIGATION, 1997, 99 (01) :106-109
[7]
Effect of activation and inhibition of the renin-angiotensin system on plasma PAI-1 [J].
Brown, NJ ;
Agirbasli, MA ;
Williams, GH ;
Litchfield, WR ;
Vaughan, DE .
HYPERTENSION, 1998, 32 (06) :965-971
[8]
Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk [J].
Buchner, Nikolaus J. ;
Sanner, Bernd M. ;
Borgel, Jan ;
Rump, Lars C. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2007, 176 (12) :1274-1280
[9]
Effects of nasal continuous positive airway pressure on soluble cell adhesion molecules in patients with obstructive sleep apnea syndrome [J].
Chin, K ;
Nakamura, T ;
Shimizu, K ;
Mishima, M ;
Nakamura, T ;
Miyasaka, M ;
Ohi, M .
AMERICAN JOURNAL OF MEDICINE, 2000, 109 (07) :562-567
[10]
Acute release of plasminogen activator inhibitor-1 in ST-segment elevation myocardial infarction predicts mortality [J].
Collet, JP ;
Montalescot, G ;
Vicaut, E ;
Ankri, A ;
Walylo, F ;
Lesty, C ;
Choussat, R ;
Beygui, F ;
Borentain, M ;
Vignolles, N ;
Thomas, D .
CIRCULATION, 2003, 108 (04) :391-394