Obstructive Sleep Apnea, Hypertension, and Their Interaction on Arterial Stiffness and Heart Remodeling

Increased arterial stiffness in obstructive sleep apnea: a systematic review

“…Tsioufis et al 42 found a higher cfPWV in OSA patients compared with controls. Drager et al 43 noted that although cfPWV was higher in OSA patients than in controls, it was even higher in OSA patients with hypertension. Another study by the same group compared the cfPWV of non-OSA controls with a mild to moderate OSA group, and a severe OSA group.…”

“…The methods of assessing arterial stiffness also differed between studies; however, it is encouraging that eight studies used cfPWV, AIx or both as parameters of arterial stiffness. [42][43][44][45]47,48,53,54 Furthermore, limiting our search to English language publications may have led to an omission of potentially relevant studies. Owing to methodological constraints, a meta-analysis of studies aiming to also quantify the overall magnitude of the effect of OSA on arterial stiffness could not be conducted.…”

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

“…Independently from hypertension and obesity, OSA impairs LV diastolic function, begets LVH, and thus may hasten HFpEF progression 126, 127, 252, 253, 254, 255, 256, 257, 258. Repetitive sleep arousals and hypoxic episodes heighten sympathetic activity and promote endothelial dysfunction, systemic inflammation, and arterial stiffness that may further increase blood pressure and accelerate atherosclerosis progression 128, 259, 260, 261, 262, 263, 264, 265…”

Avanços recentes do impacto da apneia obstrutiva do sono na hipertensão arterial sistêmica

“…However, the presence of OSA and SH in the same individual seems to have an additive effect on the occurrence of vascular damage and cardiac remodeling when compared to each factor individually 52,53 (Figure 2). Although the mechanisms of cardiac remodeling in OSA are not fully understood, increased arterial stiffness of the great arteries is believed to contribute to increase the left ventricular afterload 52 . Also, negative intrathoracic pressure during apneas may contribute to increase the left ventricular transmural pressure.…”

“…Recent evidences suggest that the presence of OSA is associated with a higher frequency of target-organ damage regardless of other confounding factors such as SH and obesity 51,52 . However, the presence of OSA and SH in the same individual seems to have an additive effect on the occurrence of vascular damage and cardiac remodeling when compared to each factor individually 52,53 (Figure 2).…”