Huang Zhihua, Zhao Qing, Zhao Zhihui, Thomas Robert Joseph, Duan Anqi, Li Xin, Zhang Sicheng, Gao Luyang, An Chenhong, Wang Yijia, Li Sicong, Wang Qi, Luo Qin, Liu Zhihong
Center for Respiratory and Pulmonary Vascular Diseases, Department of Cardiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, United States.
Sleep Med. 2025 Feb;126:248-259. doi: 10.1016/j.sleep.2024.12.019. Epub 2024 Dec 21.
As cardiovascular disease (CVD) incidence and mortality rates continue to rise in China, the importance of identifying and managing CVD risk factors grows. Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder, affecting an estimated 936 million individuals aged 30-69 worldwide, with China leading globally with about 176 million affected. Increasing research indicates a close association between OSA and the onset and progression of various CVD, significantly affecting outcomes. However, OSA has long been underrecognized and undertreated in CVD clinical practice. To address this gap, a multidisciplinary expert panel developed evidence-based recommendations using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology and the Delphi process. This consensus provides 17 recommendations on core clinical issues such as screening, diagnosis, treatment, and follow-up of CVD patients with OSA, aiming to standardize care and improve patient outcomes. The recommendations were informed by current evidence-based research and extensive expert consensus discussions. This approach seeks to support clinical decision-making, improve the quality of care, and address the unique challenges of managing OSA in Chinese CVD patients.
随着中国心血管疾病(CVD)的发病率和死亡率持续上升,识别和管理心血管疾病风险因素的重要性日益凸显。阻塞性睡眠呼吸暂停(OSA)是一种常见的与睡眠相关的呼吸障碍,全球约有9.36亿30 - 69岁的人受其影响,中国受影响人数约为1.76亿,位居全球之首。越来越多的研究表明,OSA与各种心血管疾病的发生和发展密切相关,对疾病转归有显著影响。然而,在心血管疾病临床实践中,OSA长期以来一直未得到充分认识和治疗。为弥补这一差距,一个多学科专家小组采用推荐分级、评估、制定与评价(GRADE)方法和德尔菲法制定了基于证据的建议。本共识针对OSA合并心血管疾病患者的筛查、诊断、治疗及随访等核心临床问题提出了17条建议,旨在规范治疗并改善患者预后。这些建议以当前基于证据的研究和广泛的专家共识讨论为依据。这种方法旨在支持临床决策、提高医疗质量,并应对中国心血管疾病患者中OSA管理的独特挑战。