The relationship of obstructive sleep apnea and cardiovascular diseases from the perspective of evidence-based medicine. Part 2
Abstract
The results of prospective studies, meta-analyzes and systematic reviews on the associations of obstructive sleep apnea (OSA) with various cardiovascular diseases (CVD) were analyzed. The second part is devoted to the analysis of the relationship between OSA and CVD such as coronary artery disease, cerebrovascular disease, heart failure, pulmonary hypertension. All of them are associated with breathing-related sleep disorders. Among these diseases, the most significant associations were revealed for OSA and heart failure, OSA and cerebrovascular disease. Separately, the relationship of OSA with cardiovascular mortality is discussed. Most observational studies have shown that OSA without treatment increases mortality rate.
About the Authors
M. V. Agaltsov
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Moscow
Russian Federation
Moscow
O. M. Drapkina
National Medical Research Center for Therapy and Preventive Medicine
Moscow
Moscow
References
1. Garvey JF, Pengo MF, Drakatos P, et al. Epidemiological aspects of obstructive sleep apnea. J Thorac Dis. 2015;7:920-9. doi:10.3978/j.issn.2072-1439.2015.04.52.
2. Lévy P, Ryan S, Oldenburg O, et al. Sleep apnoea and the heart. Eur Respir Rev. 2013;22:333-52. doi:10.1183/09059180.00004513.
3. Ludka O, Stepanova R, Vyskocilova M, et al. Sleep apnea prevalence in acute myocardial infarction — the Sleep Apnea in Post-acute Myocardial Infarction Patients (SAPAMI) Study. Int J Cardiol. 2014;176:13-9. doi:10.1016/j.ijcard.2014.06.020.
4. Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up. Am J Respir Crit Care Med. 2002;166:159-65. doi:10.1164/rccm.2105124.
5. Marin JM, Carrizo SJ, Vicente E, et al. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046-53. doi:10.1016/S0140-6736(05)71141-7.
6. Buchner S, Satzl A, Debl K, et al. Impact of sleep-disordered breathing on myocardial salvage and infarct size in patients with acute myocardial infarction. Eur Heart J. 2014;35:192-9. doi:10.1093/eurheartj/eht450.
7. Lee CH, Sethi R, Li R, et al. Obstructive sleep apnea and cardiovascular events after percutaneous coronary intervention. Circulation. 2016;133:2008-17. doi:10.1161/CIRCULATIONAHA.115.019392.
8. Leão S, Conde B, Fontes P, et al. Effect of obstructive sleep apnea in acute coronary syndrome. Am J Cardiol. 2016;117:1084-7. doi:10.1016/j.amjcard.2015.12.053.
9. Gottlieb DJ, Yenokyan G, Newman AB, et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation. 2010;122:352-60. doi:10.1161/CIRCULATIONAHA.109.901801
10. Dong JY, Zhang YH, Qin LQ. Obstructive sleep apnea and cardiovascular risk: meta-analysis of prospective cohort studies. Atherosclerosis. 2013;229:489-95. doi:10.1016/j.atherosclerosis.2013.04.026. Epub 2013 May 3.
11. Loke YK, Brown JW, Kwok CS, et al. Association of obstructive sleep apnea with risk of serious cardiovascular events: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2012;5:720-8. doi:10.1161/CIRCOUTCOMES.111.964783.
12. Birkbak J, Clark AJ, Rod NH. The Effect of Sleep Disordered Breathing on the Outcome of Stroke and Transient Ischemic Attack: A Systematic Review. J Clin Sleep Med. 2014;10:103-8. doi:10.5664/jcsm.3376.
13. Capampangan DJ, Wellik KE, Parish JM, et al. Is obstructive sleep apnea an independent risk factor for stroke? A critically appraised topic. Neurologist. 2010;16:269-73. doi:10.1097/NRL.0b013e3181e5a66c.
14. Hermann DM, Bassetti CL. Role of sleep-disordered breathing and sleep-wake disturbances for stroke and stroke recovery. Neurology. 2016;87:1407-16. doi:10.1212/WNL.0000000000003037.
15. Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2160-236. doi:10.1161/STR.0000000000000024.
16. Marshall NS, Wong KK, Cullen SR, et al. Snoring is not associated with all-cause mortality, incident cardiovascular disease, or stroke in the Busselton Health Study. Sleep. 2012;35:1235-40. doi:10.5665/sleep.2076.
17. Lee SA, Amis TC, Byth K, et al. Heavy snoring as a cause of carotid artery atherosclerosis. Sleep. 2008;31:1207-13.
18. Dong R, Dong Z, Liu H, et al. Prevalence, Risk Factors, Outcomes, and Treatment of Obstructive Sleep Apnea in Patients with Cerebrovascular Disease: A Systematic Review. J Stroke Cerebrovasc Dis. 2018;27:1471-80. doi:10.1016/j.jstrokecerebrovasdis.2017.12.048.
19. Johnson KG, Johnson DC. Frequency of sleep apnea in stroke and TIA patients: a meta-analysis. J Clin Sleep Med. 2010 Apr 15;6(2):131-7.
20. Harbison J, Ford GA, James OF, et al. Sleep-disordered breathing following acute stroke. QJM. 2002 Nov;95(11):741-7. doi:10.1093/qjmed/95.11.741.
21. Muñoz R, Durán-Cantolla J, Martinez-Vila E, et al. Central sleep apnea is associated with increased risk of ischemic stroke in the elderly. Acta Neurol Scand. 2012;126:183-8 doi:10.1111/j.1600-0404.2011.01625.x.
22. Siccoli MM, Valko PO, Hermann DM, et al. Central periodic breathing during sleep in 74 patients with acute ischemic stroke — neurogenic and cardiogenic factors. J Neurol. 2008;255:1687-92. doi:10.1007/s00415-008-0981-9.
23. Yaranov DM, Smyrlis A, Usatii N, et al. Effect of Obstructive Sleep Apnea on Frequency of Stroke in Patients With Atrial Fibrillation. Am J Cardiol. 2015;115:461-5. doi:10.1016/j.amjcard.2014.11.027.
24. Brown DL, Shafie-Khorassani F, Kim S, et al. Sleep-Disordered Breathing Is Associated With Recurrent Ischemic Stroke. Stroke. 2019;50:571-6. doi:10.1161/STROKEAHA.118.023807.
25. Sahlin C, Sandberg O, Gustafson Y, et al. Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up. Arch Intern Med. 2008;168:297-301. doi:10.1001/archinternmed.2007.70.
26. Javaheri S, Blackwell T, Ancoli-Israel S, et al. Sleep-disordered breathing and incident of heart failure in older men. Am J Respir Crit Care Med. 2016;193:561-8. doi:10.1164/rccm.201503-0536OC.
27. Herrscher TE, Akre H, Øverland B, et al. High prevalence of sleep apnea in heart failure outpatients: even in patients with preserved systolic function. J Card Fail. 2011;17:420-5 doi:10.1016/j.cardfail.2011.01.013.
28. Jelic S, LeJemtel TH. Sleep-disordered breathing in acute decompensated heart failure. Curr Heart Fail Rep. 2009 Sep;6(3):169-75. doi:10.1007/s11897-009-0024-6.
29. Oldenburg O, Wellmann B, Buchholz A, et al. Nocturnal hypoxaemia is associated with increased mortality in stable heart failure patients. Eur Heart J. 2016;37:1695-703. doi:10.1093/eurheartj/ehv624.
30. Bitter T, Faber L, Hering D, et al. Sleep-disordered breathing in heart failure with normal left ventricular ejection fraction. Eur J Heart Fail. 2009;11:602-8. doi:10.1093/eurjhf/hfp057.
31. Hla KM, Young T, Hagen EW, et al. Coronary heart disease incidence in sleep disordered breathing: the Wisconsin Sleep Cohort Study. Sleep. 2015;38:677-84. doi:10.5665/sleep.4654.
32. Arzt M, Young T, Finn L, et al. Sleepiness and sleep in patients with both systolic heart failure and obstructive sleep apnea. Arch Intern Med. 2006;166:1716-22. doi:10.1001/archinte.166.16.1716.
33. Simonneau G, Gatzoulis MA, Adatia I, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2013;62:D34-41. doi:10.1016/j.jacc.2013.10.029.
34. Dumitrascu R, Tiede H, Eckermann J, et al. Sleep apnea in precapillary pulmonary hypertension. Sleep Med. 2013;14:247- 51. doi:10.1016/j.sleep.2012.11.013.
35. Wong HS, Williams A, Mok Y. The relationship between pulmonary hypertension and obstructive sleep apnea. Curr Opin Pulm Med. 2017;23:517-21. doi:10.1097/MCP.0000000000000421.
36. Minai OA, Ricaurte B, Kaw R, et al. Frequency and impact of pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am J Cardiol. 2009;104:1300-6. doi:10.1016/j.amjcard.2009.06.048.
37. Sajkov D, Wang T, Saunders NA, et al. Daytime pulmonary hemodynamics in patients with obstructive sleep apnea without lung disease. Am J Respir Crit Care Med. 1999; 159(5 Pt 1):1518- 26. doi:10.1164/ajrccm.159.5.9805086.
38. Gami AS, Olson EJ, Shen WK, et al. Obstructive sleep apnea and the risk of sudden cardiac death: a longitudinal study of 10,701 adults. J Am Coll Cardiol. 2013;62:610-6. doi:10.1016/j.jacc.2013.04.080.
39. Young T, Finn L, Peppard PE, et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep. 2008;31:1071-8.
40. Punjabi NM, Caffo BS, Goodwin JL, et al. Sleep- Disordered Breathing and Mortality: A Prospective Cohort Study. PLoSMed. 2009;6:e1000132. doi:10.1371/journal.pmed.1000132.
41. Marshall NS, Wong KK, Cullen SR, et al. Sleep apnea and 20-year follow-up for all-cause mortality, stroke, and cancer incidence and mortality in the Busselton Health Study cohort. J Clin Sleep Med. 2014;10:355-62. doi:10.5664/jcsm.3600.
42. Haba-Rubio J, Janssens JP, Rochat T, et al. Rapid eye movement–related disordered breathing: clinical and polysomnographic features. Chest. 2005; 128(5):3350-7. doi:10.1378/chest.128.5.3350.
43. Aurora RN, Crainiceanu C, Gottlieb DJ, et al. Obstructive Sleep Apnea during REM Sleep and Cardiovascular Disease. Am J Respir Crit Care Med. 2018;197:653-60. doi:10.1164/rccm.201706-1112OC.
Review
For citations:
Agaltsov M.V., Drapkina O.M. The relationship of obstructive sleep apnea and cardiovascular diseases from the perspective of evidence-based medicine. Part 2. Cardiovascular Therapy and Prevention. 2020;19(3):2405. (In Russ.)
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