title: Role of obstructive sleep apnea in cardiovascular disease.
abstract: OBJECTIVE
  To provide an update on the connection between obstructive sleep apnea (OSA) and cardiovascular disease.
  
  
  RESULTS
  Large prospective studies have established that OSA is associated with an increased incidence of hypertension and, in men, of coronary disease, stroke, and heart failure. Advances in understanding the pathophysiologic basis for these associations include identification of a role for OSA in inducing abnormalities in hepatic lipid-metabolizing enzymes, endothelial dysfunction, and upregulation of pro-inflammatory and pro-thrombotic mediators. A large body of data implicates OSA as playing a significant role in the occurrence and resistance to treatment of atrial fibrillation. Clinical trials have shown small-to-modest improvements in blood pressure associated with continuous positive airway pressure (CPAP) use, with smaller or uncontrolled studies suggesting that CPAP may improve cardiovascular outcomes or intermediate markers.
  
  
  CONCLUSIONS
  OSA and cardiovascular disease commonly co-aggregate. Multiple studies indicate that OSA contributes to or exacerbates cardiovascular disease, and thus may be a novel target for cardiovascular risk reduction. Although the evidence supports screening and treatment of OSA in patients at risk for cardiovascular disease, it also underscores a need for well powered clinical trials to examine the role of CPAP and other therapies in these populations.
authors: Vanderbilt Heart and Vascular Institute, Vanderbilt Medical Center, Nashville, Tennessee, USA.
authors: Ken
authors: K
authors: Monahan
authors: Susan
authors: S
authors: Redline
mesh_terms: D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000473:pathology*; D050171:Dyslipidemias / Q000453:epidemiology / Q000473:pathology; D004730:Endothelium, Vascular / Q000473:pathology; D006333:Heart Failure / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000473:pathology; D050356:Lipid Metabolism; D012307:Risk Factors; D040242:Risk Reduction Behavior; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000473:pathology*; D020521:Stroke / Q000453:epidemiology / Q000473:pathology; D013923:Thromboembolism / Q000453:epidemiology / Q000473:pathology