Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia ; National Health and Medical Research Council Center for Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia ; Discipline of Sleep Medicine, Sydney Medical School, University of Sydney, Sydney, Australia.
Nat Sci Sleep. 2013 May 10;5:43-52. doi: 10.2147/NSS.S34841. Print 2013.
Obstructive sleep apnea (OSA) is increasingly being recognized as a major health burden with strong focus on the associated cardiovascular risk. Studies from the last two decades have provided strong evidence for a causal role of OSA in the development of systemic hypertension. The acute physiological changes that occur during apnea promote nocturnal hypertension and may lead to the development of sustained daytime hypertension via the pathways of sympathetic activation, inflammation, oxidative stress, and endothelial dysfunction. This review will focus on the acute hemodynamic disturbances and associated intermittent hypoxia that characterize OSA and the potential pathophysiological mechanisms responsible for the development of hypertension in OSA. In addition the epidemiology of OSA and hypertension, as well as the role of treatment of OSA, in improving blood pressure control will be examined.
阻塞性睡眠呼吸暂停（OSA）日益被视为一种重大的健康负担，其与心血管风险的关联受到了强烈关注。过去二十年的研究为 OSA 在系统性高血压发展中的因果作用提供了有力证据。呼吸暂停期间发生的急性生理变化会促进夜间高血压，并可能通过交感神经激活、炎症、氧化应激和内皮功能障碍等途径导致日间持续性高血压的发展。本综述将重点关注 OSA 的急性血液动力学紊乱和相关间歇性缺氧特征，以及导致 OSA 中高血压发展的潜在病理生理机制。此外，还将探讨 OSA 和高血压的流行病学，以及治疗 OSA 改善血压控制的作用。
