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Sleep Med Rev. 2014 Oct;18(5):379-91. doi: 10.1016/j.smrv.2014.01.004. Epub 2014 Feb 3.

Systematic review on noninvasive assessment of subclinical cardiovascular disease in obstructive sleep apnea: new kid on the block!

Author information

1
Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami FL, USA; University of Manchester School of Medicine, Manchester, United Kingdom.
2
Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami FL, USA.
3
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
4
Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA.
5
Baptist Hospital of Miami and Baptist Cardiac & Vascular Institute, Miami, FL, USA.
6
Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA.
7
Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami FL, USA; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA; Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA; Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA. Electronic address: KhurramN@baptisthealth.net.

Abstract

Patients with obstructive sleep apnea (OSA) have a high burden of cardiovascular disease (CVD) but a causal relationship between OSA and atherosclerotic CVD remains unclear. We systematically reviewed the literature analyzing the relationship. A review of the Medline database for studies noninvasively evaluating subclinical CVD in OSA was conducted. A total of fifty-two studies were included in this review. Across the studies the prevalence of atherosclerosis, as assessed by coronary artery calcification, carotid intima-media thickness, brachial artery flow-mediated dilation and pulse wave velocity was higher in patients with OSA and correlated with increasing severity and duration of OSA. This study shows OSA is an independent predictor of subclinical CVD as CVD is more likely to occur in patients with long standing and severe OSA. Further research is however necessary to identify specific OSA populations that would benefit from aggressive screening.

KEYWORDS:

Atherosclerosis; Cardiovascular disease; Coronary artery calcium; Endothelial dysfunction; Flow-mediated dilation; Intima media thickness; Obstructive sleep apnea; Pulse wave velocity

PMID:
24650521
DOI:
10.1016/j.smrv.2014.01.004
[Indexed for MEDLINE]
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