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阻塞性睡眠呼吸暂停综合征:持续气道正压通气治疗预防心血管风险

Obstructive Sleep Apnoea Syndrome: Continuous Positive Airway Pressure Therapy for Prevention of Cardiovascular Risk.

作者信息

Resano-Barrio María Pilar, Arroyo-Espliguero Ramón, Viana-Llamas María Carmen, Mediano Olga

机构信息

Department of Respiratory Medicine, University Hospital Guadalajara, Spain.

Department of Cardiology, University Hospital Guadalajara, Spain.

出版信息

Eur Cardiol. 2020 Sep 29;15:e65. doi: 10.15420/ecr.2020.10. eCollection 2020 Feb.

Abstract

Obstructive sleep apnoea (OSA) syndrome is characterised by the presence of apnoea or obstructive hypopnoea during sleep, accompanied by hypoxia. It is estimated that the syndrome affects approximately 10% of men and 15% of women. Diagnosis and treatment rates have increased in recent years, but the condition remains undiagnosed in a high percentage of patients. Recent evidence suggests that OSA may increase the risk of cardiovascular disease. The relationship between OSA and cardiovascular disease can be explained, at least in part, by the coexistence of cardiovascular risk factors in the two pathologies, such as age, overweight, smoking and sedentary lifestyle. However, OSA has been independently associated with the risk of developing hypertension, cerebrovascular disease, ischaemic heart disease, heart failure and arrhythmias. Clinical trials that have evaluated the efficacy of continuous positive airway pressure (CPAP) treatment in primary and secondary cardiovascular prevention have not demonstrated a significant reduction in the incidence or recurrence of cardiovascular events. This article analyses the relationship between OSA and cardiovascular risk and discusses recent clinical trials on the efficacy of CPAP in primary and secondary cardiovascular prevention.

摘要

阻塞性睡眠呼吸暂停(OSA)综合征的特征是睡眠期间出现呼吸暂停或阻塞性呼吸不足,并伴有缺氧。据估计,该综合征影响约10%的男性和15%的女性。近年来,诊断率和治疗率有所提高,但仍有很大比例的患者未被诊断出来。最近的证据表明,OSA可能会增加心血管疾病的风险。OSA与心血管疾病之间的关系至少可以部分地通过两种病症中共存的心血管危险因素来解释,如年龄、超重、吸烟和久坐不动的生活方式。然而,OSA已独立地与患高血压、脑血管疾病、缺血性心脏病、心力衰竭和心律失常的风险相关联。评估持续气道正压通气(CPAP)治疗在一级和二级心血管预防中的疗效的临床试验并未证明心血管事件的发生率或复发率有显著降低。本文分析了OSA与心血管风险之间的关系,并讨论了近期关于CPAP在一级和二级心血管预防中的疗效的临床试验。

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