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摘要: 心血管疾病是国人死亡的首要原因。随着基于心血管疾病传统危险因素防治策略的普及,近年来心血管疾病的防治迎来瓶颈期,亟需研究新的危险因素及发病机制,探寻新的防治方案。阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)已经被证明是多种心血管疾病新的独立危险因素。由于OSA的高患病率、低知晓率和低治疗率,其已成为心血管疾病防治的热点和重点之一。心血管医生应充分认识OSA对心血管健康的危害,加强OSA筛查、健康宣教和综合干预。当前,OSA导致心血管病的致病机制仍有待阐明,缺乏行之有效的防治手段,且相关循证医学证据严重不足。未来需深入研究OSA相关心血管损伤的机制,探索有效的干预方式,并设计高质量的临床研究指导临床实践,从而改善心血管疾病患者的临床预后。Abstract: Cardiovascular disease is the leading cause of death in China. With the popularization of standard treatment based on traditional risk factors for cardiovascular diseases, the prevention and treatment of cardiovascular diseases has ushered in a bottleneck period in recent years. It is urgent to study new risk factors and pathogenesis of cardiovascular disease. Obstructive sleep apnea(OSA) has been shown to be a new independent risk factor for cardiovascular diseases. Given its widespread prevalence, low public awareness, and suboptimal treatment rates, OSA has become a hot topic in the research of cardiovascular disease. It is important for cardiologist to have a comprehensive understanding of the adverse effects of OSA and actively promote OSA screening and intervention for their patients. Currently, the association between OSA and cardiovascular diseases remains insufficiently investigated. Thus, there is a critical need for high-quality research aimed at improving our understanding of and developing effective treatments for OSA, to ultimately enhance the quality of care for patients with cardiovascular disease.
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Key words:
- obstructive sleep apnea /
- cardiovascular diseases /
- risk factors
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[1] 中国心血管健康与疾病报告2021概要[J]. 中国循环杂志, 2022, 37(6): 553-578
[2] Figtree Ga, Vernon ST, Hadziosmanovic N, et al. Mortality in STEMI patients without standard modifiable risk factors: a sex-disaggregated analysis of SWEDEHEART registry data[J]. Lancet, 2021, 397(10279): 1085-1094. doi: 10.1016/S0140-6736(21)00272-5
[3] Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association[J]. Circulation, 2022, 146(5): e18-e43.
[4] Benjafield AV, Ayas NT, Eastwood PR, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis[J]. Lancet Respir Med, 2019, 7(8): 687-698. doi: 10.1016/S2213-2600(19)30198-5
[5] 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[J]. Circulation, 2010, 122(4): 352-360. doi: 10.1161/CIRCULATIONAHA.109.901801
[6] Yeghiazarians Y, Jneid H, Tietjens JR, et al. Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association[J]. Circulation, 2021, 144(3): e56-e67.
[7] Wang X, Fan J, Guo R, et al. Association of obstructive sleep apnoea with cardiovascular events in women and men with acute coronary syndrome[J]. Eur Respir J, 2023, 61(1): 2201110. doi: 10.1183/13993003.01110-2022
[8] Sánchez-de-la-Torre M, Sánchez-de-la-Torre A, Bertran S, et al. Effect of obstructive sleep apnoea and its treatment with continuous positive airway pressure on the prevalence of cardiovascular events in patients with acute coronary syndrome(ISAACC study): a randomised controlled trial[J]. Lancet Respir Med, 2020, 8(4): 359-367. doi: 10.1016/S2213-2600(19)30271-1
[9] Fan J, Wang X, Ma X, et al. Association of Obstructive Sleep Apnea With Cardiovascular Outcomes in Patients With Acute Coronary Syndrome[J]. J Am Heart Assoc, 2019, 8(2): e010826. doi: 10.1161/JAHA.118.010826
[10] Javaheri S, Barbe F, Campos-Rodriguez F, et al. Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences[J]. J Am Coll Cardiol, 2017, 69(7): 841-858. doi: 10.1016/j.jacc.2016.11.069
[11] Torres G, Sánchez-de-la-Torre M, Barbé F. Relationship Between OSA and Hypertension[J]. Chest, 2015, 148(3): 824-832. doi: 10.1378/chest.15-0136
[12] Arias M, García-Río F, Alonso-Fernández A, et al. Obstructive sleep apnea syndrome affects left ventricular diastolic function: effects of nasal continuous positive airway pressure in men[J]. Circulation, 2005, 112(3): 375-383. doi: 10.1161/CIRCULATIONAHA.104.501841
[13] Wang H, Parker JD, Newton GE, et al. Influence of obstructive sleep apnea on mortality in patients with heart failure[J]. J Am Coll Cardiol, 2007, 49(15): 1625-1631. doi: 10.1016/j.jacc.2006.12.046
[14] Shahar E, Whitney CW, Redline S, et al. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study[J]. Am J Respir Crit Care Med, 2001, 163(1): 19-25.
[15] Khattak HK, Hayat F, Pamboukian SV, et al. Obstructive Sleep Apnea in Heart Failure: Review of Prevalence, Treatment with Continuous Positive Airway Pressure, and Prognosis[J]. Tex Heart InstJ, 2018, 45(3): 151-161. doi: 10.14503/THIJ-15-5678
[16] Somers VK, White DP, Amin R, et al. Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing[J]. J Am Coll Cardiol, 2008, 52(8): 686-717. doi: 10.1016/j.jacc.2008.05.002
[17] Mcevoy RD, Antic NA, Heeley E, et al. CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea[J]. New Engl J Med, 2016, 375(10): 919-931. doi: 10.1056/NEJMoa1606599
[18] Peker Y, Glantz H, Eulenburg C, et al. Effect of Positive Airway Pressure on Cardiovascular Outcomes in Coronary Artery Disease Patients with Nonsleepy Obstructive Sleep Apnea. The RICCADSA Randomized Controlled Trial[J]. Am J Respir Crit Care Med, 2016, 194(5): 613-620. doi: 10.1164/rccm.201601-0088OC
[19] André S, Andreozzi F, Van Overstraeten C, et al. Cardiometabolic comorbidities in obstructive sleep apnea patients are related to disease severity, nocturnal hypoxemia, and decreased sleep quality[J]. Respir Res, 2020, 21(1): 35. doi: 10.1186/s12931-020-1284-7
[20] Southwell C, Moallem M, Auckley D. Cardiologist's knowledge and attitudes about obstructive sleep apnea: a survey study[J]. Sleep Breath, 2008, 12(4): 295-302. doi: 10.1007/s11325-008-0170-1
[21] Chen X, Wang R, Zee P, et al. Racial/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis(MESA)[J]. Sleep, 2015, 38(6): 877-888.
[22] Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice[J]. Eur Heart J, 2021, 42(34): 3227-3337. doi: 10.1093/eurheartj/ehab484
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