Pontificia Universidad Católica de Chile, Alameda, 340, Santiago, Chile.
Curr Hypertens Rep. 2017 May;19(5):38. doi: 10.1007/s11906-017-0735-0.
Obstructive sleep apnea (OSA), a common breathing disorder, is recognized as an independent risk factor for systemic hypertension. Among the alterations induced by OSA, the chronic intermittent hypoxia (CIH) is considered the main factor for the hypertension. Exposure of rodents to CIH is the gold-standard method to study the mechanisms involved in the cardiovascular alterations induced by OSA. Although it is well known that CIH produces hypertension, the underlying mechanisms are not totally elucidated. It is likely that the CIH-induced systemic oxidative stress and inflammation may elicit endothelial dysfunction and increase the arterial blood pressure. In addition, OSA patients and animals exposed to CIH show sympathetic hyperactivity and potentiated cardiorespiratory responses to acute hypoxia, suggesting that CIH enhances the peripheral hypoxic chemoreflex. Recent experimental evidences support the proposal that CIH selectively enhances carotid body (CB) chemosensory reactivity to oxygen, which in turn increases sympathetic outflow leading to neurogenic hypertension. In this review, we will discuss the supporting evidence for a critical role of the CB in the generation and maintenance of the hypertension induced by CIH, also, the contribution of oxidative stress to enhance CB chemosensory drive and the activation of sympathetic-related centers in the brain.
阻塞性睡眠呼吸暂停(OSA)是一种常见的呼吸障碍,被认为是全身高血压的独立危险因素。在 OSA 引起的改变中,慢性间歇性低氧(CIH)被认为是导致高血压的主要因素。将啮齿动物暴露于 CIH 是研究 OSA 引起的心血管改变所涉及的机制的金标准方法。尽管众所周知 CIH 会导致高血压,但潜在的机制尚未完全阐明。CIH 引起的全身氧化应激和炎症可能会引发内皮功能障碍并增加动脉血压。此外,暴露于 CIH 的 OSA 患者和动物表现出交感神经活性增加和对急性低氧的心肺反应增强,表明 CIH 增强了外周缺氧化学感受器反射。最近的实验证据支持这样一种观点,即 CIH 选择性增强颈动脉体(CB)对氧的化学敏感性反应,从而增加交感神经输出导致神经原性高血压。在这篇综述中,我们将讨论 CB 在 CIH 引起的高血压的产生和维持中起关键作用的支持证据,还将讨论氧化应激增强 CB 化学感受器驱动以及大脑中与交感神经相关中心激活的作用。