Assallum Hussein, Song Tian Yue, Aronow Wilbert S, Chandy Dipak
Division of Pulmonary, Critical Care, and Sleep Medicine, New York Medical College, Valhalla, NY, USA.
Division of Cardiology, New York Medical College, Valhalla, NY, USA.
Arch Med Sci. 2019 Oct 8;17(5):1200-1212. doi: 10.5114/aoms.2019.88558. eCollection 2021.
As obesity becomes more common worldwide, the prevalence of obstructive sleep apnoea (OSA) continues to rise. Obstructive sleep apnoea is a well-known disorder that causes chronic intermittent hypoxia (CIH), which is considered a risk factor for atherosclerosis directly and indirectly. Ischaemic heart disease remains the leading cause of death. Most risk factors for atherosclerosis are well understood. However, other factors such as CIH are less well understood. Several studies have investigated the pathophysiology of CIH, attempting to uncover its link to atherosclerosis and to determine whether OSA treatment can be a therapeutic modality to modify the risk for atherosclerosis. In this article, we will review the pathophysiology of OSA as an independent risk factor for cardiovascular disease and discuss the most common markers that have been studied. We will also examine the potential impact of OSA management as a risk factor modifier on the reversibility of atherosclerosis.
随着肥胖在全球范围内变得越来越普遍,阻塞性睡眠呼吸暂停(OSA)的患病率持续上升。阻塞性睡眠呼吸暂停是一种众所周知的疾病,会导致慢性间歇性缺氧(CIH),而慢性间歇性缺氧被认为是动脉粥样硬化的直接和间接危险因素。缺血性心脏病仍然是主要的死亡原因。大多数动脉粥样硬化的危险因素已为人熟知。然而,诸如慢性间歇性缺氧等其他因素却鲜为人知。几项研究已经对慢性间歇性缺氧的病理生理学进行了调查,试图揭示其与动脉粥样硬化的联系,并确定阻塞性睡眠呼吸暂停治疗是否可以作为一种治疗方式来改变动脉粥样硬化的风险。在本文中,我们将综述阻塞性睡眠呼吸暂停作为心血管疾病独立危险因素的病理生理学,并讨论已被研究的最常见标志物。我们还将研究阻塞性睡眠呼吸暂停管理作为危险因素调节剂对动脉粥样硬化可逆性的潜在影响。