[Innovations in the epidemiology, natural history, diagnosis and treatment of sleep apnea-hypopnea syndrome].
The following review summarises the most important articles published on sleep apnea-hypopnea syndrome (SAHS) during the current year. The analysis of the many factors implicated in the risk of cardiovascular diseases associated with SAHS is currently of great interest to the scientific community. There are many studies on this subject that demonstrate the role of inflammatory and immunological mediators, their relationship with endothelial damage and their influence in the genesis of cardiovascular disease in patients with SAHS. The role of CPAP in preventing this cardiovascular risk has had varied results. Although there is no evidence of benefit or harm in its use in heart failure, in cerebrovascular accidents SAHS has been confirmed as a predisposing factor and the reported increase in mortality would justify the intention to treat SAHS in these patients. Likewise, the reduction in blood pressure found with CPAP treatment could reduce the risk of cardio-cerebrovascular disease. The recent knowledge that there is expression of multiple phenotypes of SAHS gives a glimpse in the future of a disease based on different specific phenotypes, where the traditional symptomatology that defined the syndrome does not limit its treatment. To obtain a reliable and cost-effective diagnostic method that responds to the demands of the public health problem that is SAHS, particularly in sectors of the population that remain under-diagnosed and less well known, such as children, women and the elderly population is another one of the challenges reflected in published studies. In short, the growing knowledge on the biology of SAHS, its cardiovascular implications and its effect on the morbidity and mortality of the population will enable us to understand the true dimension of this disease in the next few years.
Hernández
Concepción
C
Servicio de Neumología, Hospital Universitario de Canarias, La Laguna, Tenerife, España. CONCEPCION.HERN@telefonica.net
Durán-Cantolla
Joaquín
J
Lloberes
Patricia
P
González
Mónica
M
D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology; D002648:Child; D006801:Humans; D051437:Renal Insufficiency / Q000209:etiology; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy