Obstructive sleep apnea: An emerging risk factor for atherosclerosis

Luciano F. Drager, Vsevolod Polotsky, Geraldo Lorenzi-Filho

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)534-542
Number of pages9
JournalChest
Volume140
Issue number2
DOIs
StatePublished - Aug 1 2011

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Obstructive Sleep Apnea
Atherosclerosis
Stroke
Myocardial Infarction
Carotid Artery Diseases
Continuous Positive Airway Pressure
Lymphocyte Activation
Dyslipidemias
Lipid Peroxidation
Blood Vessels
Insulin Resistance
Monocytes
Oxidative Stress
Cardiovascular Diseases
Randomized Controlled Trials
Animal Models
Cross-Sectional Studies
Biomarkers
Macrophages
Research Personnel

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Obstructive sleep apnea : An emerging risk factor for atherosclerosis. / Drager, Luciano F.; Polotsky, Vsevolod; Lorenzi-Filho, Geraldo.

In: Chest, Vol. 140, No. 2, 01.08.2011, p. 534-542.

Research output: Contribution to journalArticle

Drager, Luciano F. ; Polotsky, Vsevolod ; Lorenzi-Filho, Geraldo. / Obstructive sleep apnea : An emerging risk factor for atherosclerosis. In: Chest. 2011 ; Vol. 140, No. 2. pp. 534-542.
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