+ Translate

Pathophysiology of cardiovascular risk in sleep apnea syndrome (SAS)

, : Pathophysiology of cardiovascular risk in sleep apnea syndrome (SAS). Revue Neurologique 158(8-9): 785-797

Different pathophysiological mechanisms underlie the morbid associations observed between sleep apnea syndrome (SAS) and cardiovascular disease. Cardiovascular responses to apnea can be divided into acute cardiovascular modifications following each nocturnal respiratory event and chronic adaptations of the cardiovascular system. The same stimuli always trigger acute cardiovascular response: hypoxemia, hypercapnea, changes in the intra-thoracic pressure, micro-arousals. Each obstructive or central respiratory event is associated with a peak in blood pressure, changes in the heart rate, generally bradycardia at onset of apnea and tachycardia when respiration is renewed. Oxygen desaturation is the strongest stimulus explaining the observed acute cardiovascular responses. When these stimuli are repeated every night, the cardiovascular system adapts with a higher sympathetic tone and lower parasympathetic tone during the diurnal period. Baroreceptors also become less sensitive in apneic patients. Finally, endothelial function is altered in SAS patients with a desensitization of the alpha and beta-2 adrengeric receptors, altered NO-dependent vasodilatation, and hypersensitivity to vasoconstriction induced, for example, by angiotensin 2. The cardiovascular morbidity associated with SAS is currently thought to concern the development of diurnal hypertension (dose-effect response), left ventricular failure, higher risk of coronary or cerebral events. Very recently, epidemiological studies suggested that continuous positive pressure ventilation in SAS patients can reduce the cardiovascular risk.

(PDF 0-2 workdays service)

Accession: 046928953

PMID: 12386523

Submit PDF Full Text: Here

Submit PDF Full Text

No spam - Every submission is manually reviewed

Due to poor quality, we do not accept files from Researchgate

Submitted PDF Full Texts will always be free for everyone
(We only charge for PDFs that we need to acquire)

Select a PDF file:

Related references

Parati, G.; Lombardi, C.; Narkiewicz, K., 2007: Sleep apnea: epidemiology, pathophysiology, and relation to cardiovascular risk. Several studies have shown the occurrence of an independent association between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease, including arterial hypertension, ischemic heart disease, and stroke. The pathogenesis of the cardio...

Hopps, E.; Caimi, G., 2016: Obstructive Sleep Apnea Syndrome: Links Betwen Pathophysiology and Cardiovascular Complications. The prevalence of obstructive sleep apnea syndrome (OSAS) is increasing, especially in the middle-aged population. OSAS is associated with an elevated risk of cardiovascular morbidity and mortality. Arterial hypertension is often the first consequ...

Shiina, K.; Tomiyama, H.; Takata, Y.; Usui, Y.; Asano, K.; Hirayama, Y.; Nakamura, T.; Yamashina, A., 2006: Concurrent presence of metabolic syndrome in obstructive sleep apnea syndrome exacerbates the cardiovascular risk: a sleep clinic cohort study. This cross-sectional study was conducted to examine whether the obstructive sleep apnea syndrome (OSAS) is associated with elevation of the pulse wave velocity (PWV) and increase in the plasma levels of C-reactive protein (CRP), both of which are...

de Leeuw, P.W., 1999: On sleep and death: cardiovascular risk of the obstructive sleep apnea syndrome. Netherlands Journal of Medicine 54(5): 188-190

Meslier, N.; Ouksel, H.; Racineux, J.L., 2002: Obstructive sleep apnea syndrome and cardiovascular risk. Numerous studies have shown that obstructive sleep apnea syndrome (OSAS) is associated with an increased cardiovascular morbidity and mortality. Obstructive sleep apnea syndrome and cardiovascular disorders are frequent diseases. They share severa...

Russi, E.W.; Bloch, K.E., 1995: Sleep apnea syndrome, hypertension, and cardiovascular risk. Excessive daytime somnolence is the main symptom of the obstructive sleep apnea syndrome (OSAS). Repetitive upper airway obstructions during sleep are followed by arousals and consequent sleep fragmentation. Furthermore, obstructive apneas or hypo...

Laaban, J.P., 2003: Sleep apnea syndrome: a new cardiovascular risk factor?. Journees Annuelles de Diabetologie de L'hotel-Dieu: 213-224

Díaz Lobato, S.; Villasante, C., 1994: The sleep apnea syndrome as a cardiovascular risk factor. Medicina Clinica 102(9): 357-358

Teramoto, S.; Matsuse, T.; Ouchi, Y., 1999: Does the altered cardiovascular variability associated with obstructive sleep apnea contribute to development of cardiovascular disease in patients with obstructive sleep apnea syndrome?. Circulation 100(25): E136-E137

Goodson, B.Lynn.; Wung, S-Fen.; Archbold, K.Hedger., 2014: Obstructive sleep apnea hypopnea syndrome and metabolic syndrome: a synergistic cardiovascular risk factor. Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for adults in the United States. One risk factor for CVD is metabolic syndrome, which encompasses obesity, hypertension, insulin resistance, proinflammatory state, and pr...