Obstructive Sleep Apnea An Emerging Risk Factor for Atherosclerosis

Autor(es)

Drager, Luciano F. ^[1] ; Polotsky, Vsevolod Y. ^[2] ; Lorenzi-Filho, Geraldo ^[3]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Med, Hypertens Unit, BR-05403904 Sao Paulo - Brazil

^[2] Johns Hopkins Univ, Sch Med, Div Pulm & Crit Care Med, Baltimore, MD - USA

^[3] Univ Sao Paulo, Sch Med, Heart Inst InCor, Sleep Lab, Pulm Div, BR-05403904 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: CHEST; v. 140, n. 2, p. 534-542, AUG 2011.
• Citações Web of Science: 164

Resumo

Obstructive sleep apnea (OSA) is independently associated with death from cardiovascular diseases, including myocardial infarction and stroke. Myocardial infarction and stroke are complications of atherosclerosis; therefore, over the last decade investigators have tried to unravel relationships between OSA and atherosclerosis. OSA may accelerate atherosclerosis by exacerbating key atherogenic risk factors. For instance, OSA is a recognized secondary cause of hypertension and may contribute to insulin resistance, diabetes, and dyslipidemia. In addition, clinical data and experimental evidence in animal models suggest that OSA can have direct proatherogenic effects inducing systemic inflammation, oxidative stress, vascular smooth cell activation, increased adhesion molecule expression, monocyte/lymphocyte activation, increased lipid loading in macrophages, lipid peroxidation, and endothelial dysfunction. Several cross-sectional studies have shown consistently that OSA is independently associated with surrogate markers of premature atherosclerosis, most of them in the carotid bed. Moreover, OSA treatment with continuous positive airway pressure may attenuate carotid atherosclerosis, as has been shown in a randomized clinical trial. This review provides an update on the role of OSA in atherogenesis and highlights future perspectives in this important research area. CHEST 2011; 140(2):534-542 (AU)

• Processo FAPESP: 10/11681-0 - Impacto da hipóxia intermitente no clearance de lipoproteínas e na aterosclerose: uma abordagem translacional
• Beneficiário: Luciano Ferreira Drager
• Modalidade de apoio: Bolsas no Exterior - Pesquisa