The epidemiology of obstructive sleep apnoea and cardiovascular disease

Sarkar, Paroma; Mukherjee, Sutapa; Chai-Coetzer, Ching Li; McEvoy, R. Doug

doi:10.21037/jtd.2018.12.56

Cited by 53 publications

(32 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Longitudinal community and sleep clinic cohort studies support an independent relationship between OSA and new CV events 6 including stroke 7 , myocardial infarction and heart failure 8 and CV mortality and the onset of CV risk factors such as hypertension 9,10 , diabetes 11 and atrial fibrillation (AF) 12 . Meta-analyses suggest that OSA is more strongly associated with cerebrovascular than coronary artery events 13,14 , and CV risk is greater in men than women.…”

Section: Cohort Studiesmentioning

confidence: 99%

“…hypoxaemia, autonomic nervous system instability, mechanical loading of the heart and great vessels and sleep fragmentation. In light of the associations found in observational studies between OSA and CV disease and some CV risk markers6,14 , short-term randomised controlled studies of CPAP have been conducted to assess the effects of OSA treatment on key parameters of cardiovascu-…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Case of Sleep Apnoea and Cardiovascular Events

McEvoy¹

2021

BRN

Self Cite

View full text Add to dashboard Cite

For 30 years evidence has pointed to sleep apnoea being a cause of cardiovascular (CV) disease and major CV events. However, five recent large randomised controlled trials (RCTs) of positive airways pressure treatment of sleep apnoea in high CV risk populations have reported neutral results, and in one case, harm. I review the various strands of evidence in an attempt to reconcile these conflicting results arguing that: 1) Cohort and clinical case control studies have likely overestimated the CV risk associated with sleep apnoea; 2) Rodent models have similarly overstated the risk of CV injury from sleep apnoea by focussing on the effects of extremely severe intermittent hypoxia; and 3) Significant heterogeneity in susceptibility to vascular injury may exist between patients. These factors, coupled with low adherence to positive airway pressure mask treatment, may help explain the neutral results of recent RCTs. Suggestions for future research are provided.

show abstract

Section: Cohort Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

The Case of Sleep Apnoea and Cardiovascular Events

McEvoy¹

2021

BRN

Self Cite

View full text Add to dashboard Cite

show abstract

“…Obstructive sleep apnea (OSA) is frequently seen in sleep-disordered breathing, which is found in 10% of people aged 30–70 years. OSA is characterized by repeated partial or complete obstruction of the upper airway that leads to arousal during sleep due to reduced airflow [ 1 – 3 ]. A large number of studies demonstrated that OSA is closely related to cardiovascular diseases (CVDs), such as hypertension [ 4 ], arrhythmia [ 5 ], heart failure (HF) [ 6 ], and coronary artery disease [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Metoprolol prevents neuronal dendrite remodeling in a canine model of chronic obstructive sleep apnea

Yang

Zhao

et al. 2019

Acta Pharmacol Sin

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) is closely associated with central nervous system diseases and could lead to autonomic nerve dysfunction, which is often seen in neurodegenerative diseases. Previous studies have shown that metoprolol prevents several chronic OSA-induced cardiovascular diseases through inhibiting autonomic nerve hyperactivity. It remains unclear whether chronic OSA can lead to dendritic remodeling in the brain, and whether metoprolol affects the dendritic remodeling. In this study we investigated the effect of metoprolol on dendrite morphology in a canine model of chronic OSA, which was established in beagles through clamping and reopening the endotracheal tube for 4 h every other day for 12 weeks. OSA beagles were administered metoprolol (5 mg· kg −1 · d −1 ). The dendritic number, length, crossings and spine density of neurons in hippocampi and prefrontal cortices were assessed by Golgi staining. And the protein levels of hypoxia-inducible factor-1α (HIF-1α) and brain-derived neurotrophic factor (BDNF) were measured by Western blotting. We showed that chronic OSA successfully induced significant brain hypoxia evidenced by increased HIF-1α levels in CA1 region and dentate gyrus of hippocampi, as well as in prefrontal cortex. Furthermore, OSA led to markedly decreased dendrite number, length and intersections, spine loss as well as reduced BDNF levels. Administration of metoprolol effectively prevented the dendritic remodeling and spine loss induced by chronic OSA. In addition, administration of metoprolol reversed the decreased BDNF, which might be associated with the metoprolol-induced neuronal protection. In conclusion, metoprolol protects against neuronal dendritic remodeling in hippocampi and prefrontal cortices induced by chronic OSA in canine.

show abstract

“…Obstructive sleep apnea (OSA) is the most common type of sleep‐disordered breathing. It is characterized by recurrent partial or complete obstruction of the upper airways during sleep, which leads to repetitive episodes of reduction (hypopnea) or absence of airflow (apnea) and intermittent hypoxia and arousal …”

mentioning

confidence: 99%

“…It is characterized by recurrent partial or complete obstruction of the upper airways during sleep, which leads to repetitive episodes of reduction (hypopnea) or absence of airflow (apnea) and intermittent hypoxia and arousal. 1 The major risk factors for OSA are obesity, male sex, and advanced age. 2 The prevalence of OSA is continuously increasing in developed countries in conjunction with the epidemic obesity.…”

mentioning

confidence: 99%