OSA: the new cardiovascular disease

Devulapally, Kiran; Pongonis, Raymond; Khayat, Rami

doi:10.1007/s10741-008-9101-2

Cited by 45 publications

(17 citation statements)

References 136 publications

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“…OSA is a major health problem affecting up to 20% of adults in the United States and is considered a major risk factor for cardiovascular disease 3,4,56,57 , e.g., heart failure, stroke, hypertension and coronary heart disease. The link between OSA and cardiovascular disease is thought to result from repeated apneic/hypoxic-mediated activation of the sympathetic nervous system via peripheral chemoreceptors which leads to hypertension and other cardiovascular problems 56 . Previous evidence showed that C1 cells are key determinants of the sympathoexcitatory response to peripheral chemoreceptor activation 15 .…”

Section: Discussionmentioning

confidence: 99%

P2Y1 Receptors Expressed by C1 Neurons Determine Peripheral Chemoreceptor Modulation of Breathing, Sympathetic Activity, and Blood Pressure

et al. 2013

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Catecholaminergic C1 cells of the rostral ventrolateral medulla (RVLM) are key determinants of the sympathoexcitatory response to peripheral chemoreceptor activation. Over-activation of this reflex is thought to contribute to increased sympathetic activity and hypertension; however, molecular mechanisms linking peripheral chemoreceptor drive to hypertension remain poorly understood. We have recently determined that activation of P2Y1-receptors in the RVLM mimicked effects of peripheral chemoreceptor activation. Therefore, we hypothesize that P2Y1-receptors regulate peripheral chemoreceptor drive in this region. Here we determine if P2Y1-receptors are expressed by C1 neurons in the RVLM and contribute to peripheral chemoreceptor control of breathing, sympathetic activity and blood pressure. We found that injection of a specific P2Y1-receptor agonist (MRS2365) into the RVLM of anesthetized adult rats increased phrenic nerve activity (PNA) (~55%), sympathetic nerve activity (SNA) (38 ± 6%), and blood pressure (23 ± 1 mmHg), whereas application of a specific P2Y1-receptor antagonist (MRS2179) decreased peripheral chemoreceptor-mediated activation of PNA, SNA and blood pressure. To establish that P2Y1 receptors are expressed by C1 cells, we determine in the brain slice preparation using cell-attached recording techniques that cells responsive to MRS2365 are immunoreactive for tyrosine hydroxylase (TH, a marker of C1 cells), and we determine in vivo that C1 lesion animals do not respond to RVLM injection of MRS2365. These data identify P2Y1-receptors as key determinants of peripheral chemoreceptor regulation of breathing, SNA and blood pressure.

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Section: Discussionmentioning

confidence: 99%

P2Y1 Receptors Expressed by C1 Neurons Determine Peripheral Chemoreceptor Modulation of Breathing, Sympathetic Activity, and Blood Pressure

et al. 2013

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“…However, they did not describe the more serious long-term cardiovascular impacts of OSA such as stroke, hypertension, coronary artery disease, and heart failure. 43,44 This represents an opportunity for increasing awareness about the long-term consequences of sleep apnea.…”

Section: Discussionmentioning

confidence: 99%

Beliefs and Attitudes Toward Obstructive Sleep Apnea Evaluation and Treatment Among Blacks

Shaw

McKenzie

Taylor

et al. 2012

Journal of the National Medical Association

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Objective Although blacks are at higher risk for obstructive sleep apnea (OSA), they are not as likely as their white counterparts to receive OSA evaluation and treatment. This study assessed knowledge, beliefs, and attitudes towards OSA evaluation and treatment among blacks residing in Brooklyn, New York. Methods Five focus groups involving 39 black men and women (aged ≥18 years) were conducted at the State University of New York (SUNY) Downstate Medical Center in Brooklyn to ascertain barriers preventing or delaying OSA evaluation and treatment. Results Misconceptions about sleep apnea were a common theme that emerged from participants’ responses. Obstructive sleep apnea was often viewed as a type of insomnia, an age-related phenomenon, and as being caused by certain bedtime activities. The major theme that emerged about barriers to OSA evaluation was unfamiliarity with the study environment. Barriers were categorized as: problems sleeping in a strange and unfamiliar environment, unfamiliarity with the study protocol, and fear of being watched while sleeping. Barriers to continuous positive airway pressure (CPAP) treatment adoption were related to the confining nature of the device, discomfort wearing a mask while they slept, and concerns about their partner’s perceptions of treatment. Conclusion Results of this study suggest potential avenues for interventions to increase adherence to recommended evaluation and treatment of OSA. Potential strategies include reducing misconceptions about OSA, increasing awareness of OSA in vulnerable communities, familiarizing patients and their partners with laboratory procedures used to diagnose and treat OSA. We propose that these strategies should be used to inform the development of culturally and linguistically tailored sleep apnea interventions to increase awareness of OSA among blacks who are at risk for OSA and associated comorbidities.

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“…Normal sleep is a basic physiological process to maintain health by decreasing the body's metabolic rate, sympathetic nervous activity, blood pressure, and heart rate and increasing cardiac vagal tone [7] . OSA is now recognized not only as sleep-disordered breathing but also as a syndrome involving multiple organs that increases the risks of heart failure [8] , [9] , stroke [10] , and cardiovascular-related mortality; moreover, it is causally related to hypertension [11] – [13] .…”

Section: Introductionmentioning

confidence: 99%

Distinct Associations between Hypertension and Obstructive Sleep Apnea in Male and Female Patients

Yin

Zhāng

et al. 2014

PLoS ONE

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Obstructive sleep apnea (OSA) is highly associated with hypertension. However, the correlation between hypertension and OSA at different levels of severity and the influence of gender on that correlation are unclear. A total of 996 patients (776 males and 190 females) with OSA were recruited. The influence of gender on the correlation between hypertension and OSA at different stratifications of severity, based on the apnea-hypopnea index (AHI), was fully evaluated together with the major health risk factors obesity, age, and diabetes. Females with OSA were significantly older on average than males with OSA. Moreover, females had milder degrees of OSA on average than the extent of severity seen in males. The proportion of females with diabetes or hypertension was higher than that of males. The proportion of males with hypertension and obesity increased significantly with OSA, and age also increased with OSA. The percentage of females with hypertension at different degrees of OSA severity was stable at about 26% in the mild, moderate, and severe OSA groups. Among females, age was increased significantly in the moderate relative to the mild OSA group. Moreover, the proportion of obese subjects was increased significantly in the severe compared with the moderate OSA group. The proportions of males and females with diabetes were not significantly different among all OSA severity groups. An ordinal multivariate logistic regression analysis confirmed that hypertension, age, and obesity were associated with OSA severity in males, whereas only age and obesity were associated with OSA severity in females. Although the proportion of subjects with hypertension was higher in females with OSA than in males with OSA, the proportion of subjects with hypertension increased as the severity of OSA increased in males but not in females.

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OSA: the new cardiovascular disease

Cited by 45 publications

References 136 publications

P2Y1 Receptors Expressed by C1 Neurons Determine Peripheral Chemoreceptor Modulation of Breathing, Sympathetic Activity, and Blood Pressure

P2Y1 Receptors Expressed by C1 Neurons Determine Peripheral Chemoreceptor Modulation of Breathing, Sympathetic Activity, and Blood Pressure

Beliefs and Attitudes Toward Obstructive Sleep Apnea Evaluation and Treatment Among Blacks

Distinct Associations between Hypertension and Obstructive Sleep Apnea in Male and Female Patients

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