Predictors of cardiovascular risks in obstructive sleep apnea syndrome

Objective The aim of the study was to assess the predictors of cardiovascular risks in obstructive sleep apnea (OSA) syndrome. Data sources They included medical text books, medical journals, and medical websites that have updated research with keywords 'cardiovascular risks' in the title of the paper. Study selection Systematic reviews that addressed OSA syndrome and studies that addressed cardiovascular risks in OSA syndrome were included. Data extraction Special search was performed at midline with keywords 'cardiovascular risks' in the title of the papers; extraction was made, including assessment of the quality and validity of papers that met with the prior criteria that describe cardiovascular risks in OSA syndrome. Data synthesis Each study was reviewed independently; obtained data were rebuilt in new language according to the need of the researcher and arranged in topics through the article. Recent findings There is also strong evidence supporting the association between sleep apnea and hypertension, arrhythmias, and coronary heart disease, as well as overall cardiovascular mortality. OSA is accompanied by activation of multiple cardiovascular disease mechanisms. Conclusion OSA, presumably mainly through intermittent hypoxia, is associated with oxidative stress, systemic inflammation, and vascular endothelium damage and dysfunction. Both systemic inflammation and endothelial dysfunction are aggravated when sleep-disordered breathing is associated with other comorbid conditions, such as morbid obesity. There are new directions regarding upper airway collapse mechanisms, such as pharyngeal denervation. There is also strong evidence supporting the association between sleep apnea and hypertension, arrhythmias, and coronary heart disease, as well as overall cardiovascular mortality.