Sleep apnoea and cardiovascular issues

 

Multiple studies indicate that SDB contributes to or exacerbates cardiovascular disease. SDB is associated with an increased incidence of hypertension, coronary artery disease, congestive heart failure, cardiac arrhythmias, stroke, and even death1,2 .

Treating OSA with CPAP has been shown to:  Increase left ventricular ejection fraction (LVEF); reduce blood pressure; and may reduce the risk of cardiovascular fatal and non-fatal events.3-6

Key research in the area of OSA and cardiovascular diseases has found that SDB:

  • Causes hypoxia, increased intrathoracic pressure swings due to the attempts to breathe during an apnoea, and activation of the sympathetic nervous system-all of which have many negative consequences for the cardiovascular system.7-10
  • Is strongly associated with hypertension, independent of all relevant risk factors.11-14
  • Is present in more than 30% of patients with hypertension.15
  • Occurs in 80% patients with drug resistant hypertension.16
  • Treated with CPAP may result in a clinically significant drop in blood pressure. This drop is sufficient to reduce risk of a coronary heart disease event by 37% and stroke risk by 56%.17-19
  • Patients have a 2.4 times increased relative risk of heart failure, independent of other known risk factors.20
  • Treatment with CPAP in patients who also have heart failure, improves left ventricular function.21
  • Is common in patients with cardiovascular disease and occurs in 50% atrial fibrillation patients.22
  • Patients have increased levels of inflammatory, oxidative and vascular endothelial effect markers, which are associated with atherogenesis. These markers are improved when the sleep apnoea is treated with CPAP.23-26
  • When severe, significantly increases the risk of cardiovascular events. Treatment with CPAP reduces this risk.27,28

 

References