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睡眠呼吸暂停与高血压。

Sleep Apnea and Hypertension.

机构信息

Cardiology Department, IRCCS Istituto Auxologico Italiano, S. Luca Hospital, Piazza Brescia 20, 20149, Milan, Italy.

Clinica Medica, S. Gerardo dei Tintori Hospital, University Milano-Bicocca, Monza, Italy.

出版信息

High Blood Press Cardiovasc Prev. 2022 Jan;29(1):23-31. doi: 10.1007/s40292-021-00484-4. Epub 2021 Nov 5.

Abstract

Obstructive sleep apnea is a frequent finding in clinical practice especially with the obesity epidemic and the growing awareness of sleep-disordered breathing as a potential and treatable risk factor for cardiovascular diseases. It frequently coexists undiagnosed activating pathophysiological mechanisms known to participate in development and progression of cardiovascular diseases and resistance to therapeutical strategies. The sympathetic activation and the baroreflex and chemoreflex impairment appear to be the main pathophysiological factors that activating several mechanisms elicit cardiac and vascular damage. Data from cross-sectional population-based studies, prospective studies and meta-analysis have clearly shown the implication of OSA in the development of the hypertensive state and the benefits obtained by continuous positive airway pressure on daytime blood pressure and cardiovascular risk.

摘要

阻塞性睡眠呼吸暂停在临床实践中很常见,尤其是随着肥胖症的流行,以及人们越来越意识到睡眠呼吸障碍是心血管疾病的一个潜在可治疗的危险因素。它经常与未被诊断的疾病共存,激活已知参与心血管疾病发展和进展的病理生理机制,并对治疗策略产生抵抗。交感神经激活以及压力和化学感受反射受损似乎是激活多种机制引起心脏和血管损伤的主要病理生理因素。来自基于人群的横断面研究、前瞻性研究和荟萃分析的数据清楚地表明,阻塞性睡眠呼吸暂停在高血压状态的发展中起作用,以及持续气道正压通气对日间血压和心血管风险的益处。

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