Translational approaches to understanding metabolic dysfunction and cardiovascular consequences of obstructive sleep apnea

Author:

Drager Luciano F.12,Polotsky Vsevolod Y.3,O'Donnell Christopher P.4,Cravo Sergio L.5,Lorenzi-Filho Geraldo6,Machado Benedito H.7

Affiliation:

1. Hypertension Unit, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil;

2. Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo, Brazil;

3. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;

4. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;

5. Department of Physiology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil;

6. Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil; and

7. Department of Physiology, School of Medicine of Ribeirao Preto, University of São Paulo, São Paulo, Brazil

Abstract

Obstructive sleep apnea (OSA) is known to be independently associated with several cardiovascular diseases including hypertension, myocardial infarction, and stroke. To determine how OSA can increase cardiovascular risk, animal models have been developed to explore the underlying mechanisms and the cellular and end-organ targets of the predominant pathophysiological disturbance in OSA–intermittent hypoxia. Despite several limitations in translating data from animal models to the clinical arena, significant progress has been made in our understanding of how OSA confers increased cardiovascular risk. It is clear now that the hypoxic stress associated with OSA can elicit a broad spectrum of pathological systemic events including sympathetic activation, systemic inflammation, impaired glucose and lipid metabolism, and endothelial dysfunction, among others. This review provides an update of the basic, clinical, and translational advances in our understanding of the metabolic dysfunction and cardiovascular consequences of OSA and highlights the most recent findings and perspectives in the field.

Funder

São Paulo Research Foundation (FAPESP)

Publisher

American Physiological Society

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,Physiology

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