PDF(Pubmed)
Abstract：
Obstructive sleep apnea (OSA) is characterized by repeated episodes of upper airway obstruction during sleep, and it is closely linked to several cardiovascular issues due to intermittent hypoxia, nocturnal hypoxemia, and disrupted sleep patterns. Pulmonary hypertension (PH), identified by elevated pulmonary arterial pressure, shares a complex interplay with OSA, contributing to cardiovascular complications and morbidity. The prevalence of OSA is alarmingly high, with studies indicating rates of 20-30% in males and 10-15% in females, escalating significantly with age and obesity. OSA\'s impact on cardiovascular health is profound, particularly in exacerbating conditions like systemic hypertension and heart failure. The pivotal role of hypoxemia increases intrathoracic pressure, inflammation, and autonomic nervous system dysregulation in this interplay, which all contribute to PH\'s pathogenesis. The prevalence of PH among OSA patients varies widely, with studies reporting rates from 15% to 80%, highlighting the variability in diagnostic criteria and methodologies. Conversely, OSA prevalence among PH patients also remains high, often exceeding 25%, stressing the need for careful screening and diagnosis. Treatment strategies like continuous positive airway pressure (CPAP) therapy show promise in mitigating PH progression in OSA patients. However, this review underscores the need for further research into long-term outcomes and the efficacy of these treatments. This review provides comprehensive insights into the epidemiology, pathophysiology, and treatment of the intricate interplay between OSA and PH, calling for integrated, personalized approaches in diagnosis and management. The future landscape of OSA and PH management hinges on continued research, technological advancements, and a holistic approach to improving patient outcomes.
摘要：
阻塞性睡眠呼吸暂停（OSA）的特征是睡眠期间反复发作上呼吸道阻塞，它与间歇性缺氧导致的几个心血管问题密切相关，夜间低氧血症,和扰乱的睡眠模式。肺动脉高压(PH),通过肺动脉压升高来识别，与OSA共享复杂的相互作用，导致心血管并发症和发病率。OSA的患病率高得惊人，研究表明，男性的发病率为20-30%，女性为10-15%，随着年龄和肥胖的增加而显著上升。OSA对心血管健康的影响是深远的，特别是在全身性高血压和心力衰竭等恶化的情况下。低氧血症增加胸内压的关键作用，炎症,和自主神经系统在这种相互作用中失调，这些都有助于PH的发病机理。OSA患者中PH的患病率差异很大，研究报告率从15%到80%，强调诊断标准和方法的可变性。相反，PH患者的OSA患病率仍然很高，经常超过25%，强调需要仔细筛查和诊断。持续气道正压通气（CPAP）治疗等治疗策略有望减轻OSA患者的PH进展。然而,这篇综述强调需要进一步研究这些治疗的长期结局和疗效.这篇综述提供了对流行病学的全面见解，病理生理学,以及OSA和PH之间复杂相互作用的治疗，呼吁一体化，诊断和管理的个性化方法。OSA和PH管理的未来前景取决于持续的研究，技术进步,以及改善患者预后的整体方法。
