title: Translational approaches to understanding metabolic dysfunction and cardiovascular consequences of obstructive sleep apnea.
abstract: Obstructive sleep apnea (OSA) is known to be independently associated with several cardiovascular diseases including hypertension, myocardial infarction, and stroke. To determine how OSA can increase cardiovascular risk, animal models have been developed to explore the underlying mechanisms and the cellular and end-organ targets of the predominant pathophysiological disturbance in OSA-intermittent hypoxia. Despite several limitations in translating data from animal models to the clinical arena, significant progress has been made in our understanding of how OSA confers increased cardiovascular risk. It is clear now that the hypoxic stress associated with OSA can elicit a broad spectrum of pathological systemic events including sympathetic activation, systemic inflammation, impaired glucose and lipid metabolism, and endothelial dysfunction, among others. This review provides an update of the basic, clinical, and translational advances in our understanding of the metabolic dysfunction and cardiovascular consequences of OSA and highlights the most recent findings and perspectives in the field.
authors.affiliation: Hypertension Unit, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil; Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo, Brazil; luciano.drager@incor.usp.br.
authors.forename: Luciano F
authors.initials: LF
authors.lastname: Drager
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;
authors.forename: Vsevolod Y
authors.initials: VY
authors.lastname: Polotsky
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;
authors.forename: Christopher P
authors.initials: CP
authors.lastname: O'Donnell
authors.affiliation: Department of Physiology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil;
authors.forename: Sergio L
authors.initials: SL
authors.lastname: Cravo
authors.affiliation: Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil; and.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi-Filho
authors.affiliation: Department of Physiology, School of Medicine of Ribeirao Preto, University of São Paulo, São Paulo, Brazil.
authors.forename: Benedito H
authors.initials: BH
authors.lastname: Machado
mesh_terms: D000818:Animals; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000150:complications / Q000378:metabolism; D045422:Continuous Positive Airway Pressure / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism; D004195:Disease Models, Animal; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000378:metabolism*; D000860:Hypoxia / Q000150:complications / Q000378:metabolism*; D007249:Inflammation; D007333:Insulin Resistance; D050356:Lipid Metabolism; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000378:metabolism*; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000378:metabolism* / Q000628:therapy
chemical_list: D001786:Blood Glucose; D005947:Glucose
keywords: cardiovascular disease; intermittent hypoxia; sleep apnea; translational medicine