Cardiovascular consequences of obstructive sleep apnea

Abstract

The impact of obstructive sleep apnea syndrome on cardiovascular morbidity and mortality is phenomenal. There is a strong evidence base in terms of several longitudinal as well as cross-sectional studies in support of this fact. However, the evidence in favor of its association with hypertension is stronger than with coronary artery disease, arrhythmias and stroke. Prevalence studies on OSAHS have demonstrated an increased odds ratio for hypertension above the background population. Also, prevalence of hypertension is known to increase proportionate to the severity of sleep disordered breathing. Cross-sectional prevalence studies on cardiovascular disease and OSAHS have shown an increased risk of coronary artery disease (CAD) amongst patients with OSAHS. Prevalence of OSA is significantly higher in patients with atrial fibrillation (AF) than in patients without past or current AF. Pulmonary arterial hypertension, congestive heart failure and sudden cardiac death are also commonly associated with OSAHS. Interventional studies clarify the role of effective treatment of this disorder with CPAP. Therapy with CPAP, therefore, should be expected to impact the prognosis of cardiovascular consequences of this syndrome.