MSc Programme in Sleep Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Diabetes Centre, Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Curr Vasc Pharmacol. 2021;19(3):285-300. doi: 10.2174/1570161118666200318103553.
Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea syndrome (OSAS) are among the most prevalent chronic respiratory disorders. Accumulating data suggest that there is a significant burden of cardiovascular disease (CVD) in patients with COPD and OSAS, affecting negatively patients' quality of life and survival. Overlap syndrome (OS), i.e. the co-existence of both COPD and OSAS in the same patient, has an additional impact on the cardiovascular system multiplying the risk of morbidity and mortality. The underlying mechanisms for the development of CVD in patients with either OSAS or COPD and OS are not entirely elucidated. Several mechanisms, in addition to smoking and obesity, may be implicated, including systemic inflammation, increased sympathetic activity, oxidative stress and endothelial dysfunction. Early diagnosis and proper management of these patients might reduce cardiovascular risk and improve patients' survival. In this review, we summarize the current knowledge regarding epidemiological aspects, pathophysiological mechanisms and present point-to-point specific associations between COPD, OSAS, OS and components of CVD, namely, pulmonary hypertension, coronary artery disease, peripheral arterial disease and stroke.
慢性阻塞性肺疾病（COPD）和阻塞性睡眠呼吸暂停综合征（OSAS）是最常见的慢性呼吸系统疾病之一。越来越多的数据表明，COPD 和 OSAS 患者存在显著的心血管疾病（CVD）负担，这对患者的生活质量和生存率产生负面影响。重叠综合征（OS），即 COPD 和 OSAS 同时存在于同一患者中，对心血管系统有额外的影响，使发病率和死亡率的风险倍增。OSAS 或 COPD 以及 OS 患者发生 CVD 的潜在机制尚未完全阐明。除了吸烟和肥胖之外，还可能涉及一些机制，包括全身炎症、交感神经活性增加、氧化应激和内皮功能障碍。早期诊断和适当管理这些患者可能会降低心血管风险并提高患者的生存率。在这篇综述中，我们总结了目前关于 COPD、OSAS、OS 与 CVD 各组成部分（肺动脉高压、冠心病、外周动脉疾病和中风）之间的流行病学、病理生理学机制和具体关联的相关知识。
