Association Between Obstructive Sleep Apnea and Stroke and Contributory Risk Factors
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Obstructive sleep apnea (OSA), a common comorbidity in patients with stroke, has shown increasing prevalence over the past few decades. OSA is an important risk factor for stroke in addition to other well-known contributors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. Moreover, OSA is an independent predictor of neurological outcomes and mortality. The pathological mechanisms underlying the association between OSA and stroke include autonomic dysfunction, hypertension, cardiac arrhythmia, dyslipidemia, impaired glucose tolerance, hypoxia, and inflammation. Continuous positive airway pressure (CPAP) therapy has proven clinical utility in improvement of neurological symptoms in patients with stroke. Findings from a CPAP withdrawal model have shown increased sympathetic activity in OSA with a consequent significant elevation in blood pressure, relevant cerebral hypoxia, and disturbed cardiac repolarization. In this review, we present an overview of the literature that describes an association between OSA and stroke in addition to the vascular risk factors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. This study highlights the importance of early and accurate diagnosis and management of OSA for stroke prevention and care and will benefit physicians in clinical practice.Keywords:
Stroke
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Dyslipidemia
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To investigate the long-term efficacy of continuous positive airway pressure (CPAP) treatment for the elderly with obstructive sleep apnea syndrome (OSAS).Case control study was performed among 106 elderly with obstructive sleep apnea syndrome (OSAS). They were divided into treatment group (n=34) and control group (n=72), based on whether they underwent long-term CPAP treatment or not. The long-term efficacy of CPAP treatment was evaluated by long-term clinical observation.The incidence of cardiovascular events was 12% (4/34) in treatment group and 47% (34/72) in control group (P<0.01). Kaplan-Meier survival analysis showed that after controlling the factors of age, sex, body mass index, apnea hypopnea index and previous diseases, failing to receive CPAP treatment was the independent risk factor for cardiovascular events (chi2=17.0, P<0.01).CPAP treatment for moderate-severe OSAS could reduce cardiovascular and neurovascular events risk for elderly patients with OSAS.
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SYNOPSIS: Continuous positive airway pressure (CPAP) is effective therapy for the obstructive sleep apnea syndrome (OSAS). Diagnosis and treatment of OSAS with CPAP typically involves a minimum of two overnight polysomnographic (PSG) investigations in a sleep center. The first study diagnoses OSAS whereas the second is used to titrate an effective level of CPAP. The implementation of a self-adjusting automatic CPAP device makes it possible to titrate CPAP at home and avoid a second PSG study. SOURCE: Series F, Marc I. Efficacy of automatic continuous positive airway pressure therapy that uses an estimated required pressure in the treatment of the obstructive sleep apnea syndrome.
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Beneficial effect of continuous positive airway pressure therapy in obstructive sleep apnea syndrome
Continuous positive airway pressure therapy is an evidence based therapy of obstructive sleep apnea syndrome. The effective treatment of obstructive sleep apnea can decrease sympaticotonia and, consequently, blood pressure. Furhtermore, it can improve inflammatory and metabolic parameters resulting in a decreased cardiovascular risk. This article summarizes the positive effects of continuous positive airway pressure therapy on cardiovascular risk factors in obstructive sleep apnea syndrome. Orv. Hetil., 2014, 155(47), 1855–1859.
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Introduction: Obstructive sleep apnea syndrome (OSAS) is a very frequent and underdiagnosed pathology with important social and economic implications. Continuous positive airway pressure (CPAP) is the gold standard for the treatment of OSAS, but adherence is low, with multiple factors being involved in this phenomenon. The purpose of the current study is to evaluate the causes of low adherence to CPAP among adults with OSAS and patients' symptoms. Materials and methods: We performed a prospective cohort study which included 95 patients admitted to Rosiori de Vede Pneumology Hospital, who were diagnosed with OSAS between January 2021-January 2023 and had indication to receive CPAP. Patients were divided into two groups (adherents and non-adherents) and were evaluated for one year based on completing a questionnaire and downloading data from the compliance card of CPAP on their regular visits at one month, six months and 12 months after diagnosis. Results:The predictive factors identified for non-adherence included oro-nasal mask use, low OSAS severity, low level of education, type D personality, high level of daytime sleepiness, and the first period of time with CPAP. Conclusion:Obstructive sleep apnea syndrome is a frequent and underdiagnosed pathology which benefits from CPAP as the gold standard treatment option. Although therapeutic results are favourable and effects are rapidly observed in symptomatic moderate-severe OSA, adherence to therapy remains low.
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Background: Obstructive sleep apnea (OSA) is a major cause of secondary hypertension. Moreover, a considerable proportion of patients with essential hypertension have OSA. OSA also appears to increase the risk for cardiovascular disease and all-cause mortality. Continuous positive airway pressure (CPAP) treatment substantially reduces daytime somnolence and improves quality of life in patients with OSA. However, the effects of CPAP treatment on blood pressure (BP) are questionable. The aim of the present review is to summarize the evidence regarding the association between OSA with hypertension and the effects of CPAP treatment on BP in patients with OSA. The severity of OSA directly correlates with the increase in BP. Moreover, patients with OSA are at increased risk for developing hypertension. However, CPAP treatment does not result in substantial reductions in BP in unselected patients with OSA with moderate adherence to this treatment. Nevertheless, these effects are more pronounced in patients with more severe hypertension, more severe OSA and more importantly, in those who adhere to CPAP treatment. Conclusion: Therefore, it is essential to improve the adherence to CPAP treatment in order to optimally manage this important cause of hypertension. Keywords: Obstructive sleep apnea, hypertension, continuous positive airway pressure, resistant hypertension, cardiovascular risk, treatment.
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Objective To study the characteristics of dyslipidemia and phenotyping of hyperlipidemia.Methods The four lipid items and LP(a) level of 1 500 cases of the professional population were investigated.The characteristics of dyslipidemia and phenotyping of hyperlipidemia were studied.Results Only 45.2% had suitable TC,TG,LDL-C and HDL-C levels,and 53.0% had suitable TC and TG levels in all subjects.The detection rate of hyperlipidemia type Ⅱa(10.7%) was more higher than that of type Ⅳ(5.6%) and type ⅡB(1.3%).The detection rate of simultaneous high Lp(a) and LDL-C of young males was significantly higher than that of females.There wasn't statistical difference of the detection rate between males and females in other age groups.Conclusion Lipid reduction treatment should be emphasized on regulating TC and LDL-C levels.Postmenopause females and young males should pay attention to earlier prevention and treatment of dyslipidemia.
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Dyslipidemia substantially contributes to the risk of cardiovascular diseases. The polyherbal formulation has been a traditional therapeutic strategy used to treat dyslipidemia. This study was designed to evaluate the effects of a novel herbal medicine called “GANMO” on an experimental animal model with endogenous dyslipidemia and exogenous dyslipidemia. In the endogenous hyperlipidemia model, rats were previously treated with GANMO tablets and intraperitoneally injected with poloxamer 407 to induce hyperlipidemia. In the exogenous hyperlipidemia model, rats were given oral administration of oil-cholesterol mixture and GANMO for 4 consecutive weeks. Serum lipid profiles were assessed at all experimental animals. In both models, GANMO at both doses significantly decreased the serum total cholesterol (TC) level and non-high-density lipoprotein (HDL) cholesterol level as compared with the model group. HDL cholesterol levels increased in rats with high doses of GANMO compared to those with low doses. GANMO at both doses substantially reduced TG level in the endogenous hyperlipidemia model. In conclusion, GANMO tablets posed a positive effect on serum lipid modulations in dyslipidemia models.
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