Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.
Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Maturitas. 2019 Jun;124:32-34. doi: 10.1016/j.maturitas.2019.02.012. Epub 2019 Feb 28.
Obstructive sleep apnoea (OSA) is a common disorder, in which loss of pharyngeal dilator muscle tone during sleep causes recurrent collapse of the upper airway and temporary cessation of breathing. Repeated apneas and hypopneas lead to cycles of intermittent hypoxia/hypercapnia, increased negative intrathoracic pressure and arousals from sleep. These consequences of OSA are associated with a cascade of cardiovascular and neurohumoral consequences, including sympathetic nervous system hyperactivity, raised heart rate variability, increases in blood pressure, myocardial wall stress, oxidative stress, systemic inflammation, platelet aggregation and impaired vascular endothelial function, which contribute, in turn, to increased cardiovascular risk and, in particular, to the development of chronic systemic arterial hypertension and arrhythmias, especially atrial fibrillation (AF). Given that the prevalence of OSA is modified by age and gender, OSA-related cardiovascular diseases may also be affected by the same factors. This review focuses on the potential role of OSA in systemic arterial hypertension and AF, and discusses the most interesting studies on age and gender as predisposing factors.
阻塞性睡眠呼吸暂停（OSA）是一种常见疾病，其特征是睡眠期间咽扩张肌张力丧失，导致上气道反复塌陷和呼吸暂时停止。反复的呼吸暂停和低通气导致间歇性低氧/高碳酸血症、胸腔内负压增加和睡眠觉醒的循环。OSA 的这些后果与心血管和神经激素后果的级联反应有关，包括交感神经系统活性增加、心率变异性增加、血压升高、心肌壁应力增加、氧化应激、全身炎症、血小板聚集和血管内皮功能受损，这些反过来又导致心血管风险增加，特别是慢性系统性动脉高血压和心律失常的发展，尤其是心房颤动（AF）。鉴于 OSA 的患病率受年龄和性别影响，OSA 相关的心血管疾病也可能受到相同因素的影响。本综述重点关注 OSA 在系统性动脉高血压和 AF 中的潜在作用，并讨论了关于年龄和性别作为易患因素的最有趣的研究。
