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Синдром обструктивного апноэ сна и артериальная гипертония: двунаправленная взаимосвязь
Синдром обструктивного апноэ сна и артериальная гипертония: двунаправленная взаимосвязь
Литвин А.Ю., Михайлова О.О., Елфимова Е.М. и др. Синдром обструктивного апноэ сна и артериальная гипертония: двунаправленная взаимосвязь. Consilium Medicum. 2015; 17 (10): 34–39. DOI: 10.26442/2075-1753_2015.10.34-39
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Аннотация
Артериальная гипертония (АГ) – модифицируемый широко распространенный фактор риска сердечно-сосудистых заболеваний. В ряде исследований с большим количеством наблюдений предполагается, что синдром обструктивного апноэ сна (СОАС) – независимый фактор риска АГ. В этой статье обсуждаются патогенетические механизмы СОАС, рассматриваются модель двунаправленной взаимосвязи между СОАС и АГ, а также влияние СИПАП-терапии (от англ. Constant Positive Airway Pressure, CPAP) на артериальное давление у пациентов с гипертонической болезнью. В настоящее время существует много открытых вопросов, касающихся патогенеза СОАС, его влияния на сердечно-сосудистую систему и прогноз. Несмотря на то, что снижение артериального давления при СИПАП-терапии у пациентов с СОАС обычно невелико, снижение всего лишь на несколько мм рт. ст. может значительно снизить сердечно-сосудистый риск, а комбинация медикаментозной терапии с СИПАП-терапией может приводить к более существенному снижению артериального давления, особенно у лиц с трудно контролируемой АГ. Пациенты, направленные в клинику, специализирующуюся на диагностике и лечении гипертонии, должны быть обследованы на предмет наличия или отсутствия СОАС как возможного модифицируемого фактора риска.
Ключевые слова: синдром обструктивного апноэ сна, артериальная гипертония, клиника, диагностика, патогенез, лечение, СИПАП-терапия.
Ключевые слова: синдром обструктивного апноэ сна, артериальная гипертония, клиника, диагностика, патогенез, лечение, СИПАП-терапия.
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This article deals with OSA pathogenetic mechanisms, considering the model of bidirectional relationship between OSA and AH, as well as the effect of CPAP-therapy (Constant Positive Airway Pressure, CPAP) on blood pressure in hypertensive patients. There are many open questions concerning the pathogenesis of OSA, its effect on the cardiovascular system and prognosis, nowadays. Despite the fact that the decrease in blood pressure during CPAP-therapy in patients with OSA is usually small, a small drop in blood pressure, even a few mm Hg can significantly reduce the cardiovascular risk, but the combination of drug therapy and CPAP-therapy can result in significant decrease in blood pressure, especially in people with poorly controlled AH. Patients who have been attended clinics, specializing in the diagnosis and treatment of hypertension should be examined for the presence or absence of OSA as a possible modifiable risk factor.
Key words: obstructive sleep apnea syndrome, arterial hypertension, clinical findings, diagnosis, pathogenesis, treatment, CPAP-therapy.
Key words: obstructive sleep apnea syndrome, arterial hypertension, clinical findings, diagnosis, pathogenesis, treatment, CPAP-therapy.
Полный текст
Список литературы
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3. Stradling JR, Crosby JH. Predictors and prevalence of obstructive sleep apnoea and snoring in 1,001 middle aged men. Thorax 1991; 46: 85–90.
4. Young T, Palta M, Dempsey J et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993, 328: 1230–5.
5. Punjabi NM, Caffo BS, Goodwin JL et al. Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med 2009; 6: e1000132.
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7. Gottlieb DJ, Yenokyan G, Newman AB et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation 2010; 122: 352–60.
8. Redline S, Yenokyan G, Gottlieb DJ et al. Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med 2010; 182: 269–77.
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10. Trinder J, Kleiman J, Carrington M et al. Autonomic activity during human sleep as a function of time and sleep stage. J Sleep Res 2001; 10: 253–64.
11. Arzt M, Young T, Finn L et al. Sleepiness and sleep in patients with both systolic heart failure and obstructive sleep apnea. Arch Intern Med 2006; 166: 1716–22.
12. Friedman O, Bradley TD, Ruttanaumpawan P, Logan AG. Independent association of drug-resistant hypertension to reduced sleep duration and efficiency. Am J Hypertens 2010; 23: 174–9.
13. Chiu KL, Ryan CM, Shiota S et al. Fluid shift by lower body positive pressure increases pharyngeal resistance in healthy subjects. Am J Respir Crit Care Med 2006; 174: 1378–83.
14. Shiota S, Ryan CM, Chiu KL et al. Alterations in upper airway crosssectional area in response to lower body positive pressure in healthy subjects. Thorax 2007; 62: 868–72.
15. Yumino D, Wang H, Floras JS et al. Prevalence and physiological predictors of sleep apnea in patients with heart failure and systolic dysfunction. J Card Fail 2009; 15: 279–85.
16. Bassetti CL, Milanova M, Gugger M. Sleep-disordered breathing and acute ischemic stroke: diagnosis, risk factors, treatment, evolution, and long-term clinical outcome. Stroke 2006; 37: 967–72.
17. Arzt M, Young T, Peppard PE et al. Dissociation of obstructive sleep apnea from hypersomnolence and obesity in patients with stroke. Stroke 2010; 41: e129–e134.
18. Ryan CM, Bradley TD. Pathogenesis of obstructive sleep apnea. J Appl Physiol 2005; 99: 2440–50.
19. Logan AG, Perlikowski SM, Mente A et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens 2001; 19: 2271–7.
20. Roumelioti ME, Buysse DJ, Sanders MH et al. Sleep-disordered breathing and excessive daytime sleepiness in chronic kidney disease and hemodialysis. Clin J Am Soc Nephrol 2011; 6: 986–94.
21. Kasai T, Arcand J, Allard JP et al. Relationship between sodium intake and sleep apnea in patients with heart failure. J Am Coll Cardiol 2011; 58: 1970–4.
22. Witkowski A, Prejbisz A, Florczak E et al. Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea. Hypertension 2011; 58: 559–65.
23. Gaddam K, Pimenta E, Thomas SJ et al. Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: a preliminary report. J Hum Hypertens 2010; 24: 532–7.
24. Su MC, Chiu KL, Ruttanaumpawan P et al. Lower body positive pressure increases upper airway collapsibility in healthy subjects. Respir Physiol Neurobiol 2008; 161: 306–12.
25. Redolfi S, Yumino D, Ruttanaumpawan P et al. Relationship between overnight rostral fluid shift and obstructive sleep apnea in nonobese men. Am J Respir Crit Care Med 2009; 179: 241–6.
26. Yumino D, Redolfi S, Ruttanaumpawan P et al. Nocturnal rostral fluid shift: a unifying concept for the pathogenesis of obstructive and central sleep apnea in men with heart failure. Circulation 2010; 121: 1598–605.
27. Elias RM, Bradley TD, Kasai T et al. Rostral overnight fluid shift in end-stage renal disease: relationship with obstructive sleep apnea. Nephrol Dial Transplant 2012; 27: 1569–73.
28. Friedman O, Bradley TD, Chan CT et al. Relationship between overnight rostral fluid shift and obstructive sleep apnea in drug-resistant hypertension. Hypertension 2010; 56: 1077–82.
29. Jafari B, Mohsenin V. Overnight rostral fluid shift in obstructive sleep apnea: does it affect the severity of sleep-disordered breathing? Chest 2011; 140: 991–7.
30. Redolfi S, Arnulf I, Pottier M et al. Effects of venous compression of the legs on overnight rostral fluid shift and obstructive sleep apnea. Respir Physiol Neurobiol 2011; 175: 390–3.
31. Redolfi S, Arnulf I, Pottier M et al. Attenuation of obstructive sleep apnea by compression stockings in subjects with venous insufficiency. Am J Respir Crit Care Med 2012; 184: 1062–6.
32. Tang SC, Lam B, Ku PP et al. Alleviation of sleep apnea in patients with chronic renal failure by nocturnal cycler-assisted peritoneal dialysis compared with conventional continuous ambulatory peritoneal dialysis. J Am Soc Nephrol 2006; 17: 2607–16.
33. Tang SC, Lam B, Lai AS et al. Improvement in sleep apnea during nocturnal peritoneal dialysis is associated with reduced airway congestion and better uremic clearance. Clin J Am Soc Nephrol 2009; 4: 410–8.
34. Hanly PJ, Pierratos A. Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis. N Engl J Med 2001; 344: 102–7.
35. Bucca CB, Brussino L, Battisti A et al. Diuretics in obstructive sleep apnea with diastolic heart failure. Chest 2007; 132: 440–6.
36. Narkiewicz K, Somers VK. Sympathetic nerve activity in obstructive sleep apnoea. Acta Physiol Scand 2003; 177 (3): 385–90.
37. Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 1995; 96 (4): 1897–904.
38. Narkiewicz K, van de Borne PJ, Cooley RL et al. Sympathetic activity in obese subjects with and without obstructive sleep apnea. Circulation 1998; 98 (8): 772–6.
39. Carlson JT, Hedner J, Elam M et al. Augmented resting sympathetic activity in awake patients with obstructive sleep apnea. Chest 1993; 103 (6): 1763–8.
40. Fletcher EC. Sympathetic over activity in the etiology of hypertension of obstructive sleep apnea. Sleep 2003; 26 (1): 15–9.
41. Phillips BG, Somers VK. Neural and humoral mechanisms mediating cardiovascular responses to obstructive sleep apnea. Respir Physiol 2000; 119 (2–3): 181–7.
42. Brooks D, Horner RL, Kozar LF et al. Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J Clin Invest 1997; 99: 106–9.
43. Spaak J, Egri ZJ, Kubo T et al. Muscle sympathetic nerve activity during wakefulness in heart failure patients with and without sleep apnea. Hypertension 2005; 46: 1327–32.
44. Narkiewicz K, Montano N, Cogliati C et al. Altered cardiovascular variability in obstructive sleep apnea. Circulation 1998; 98 (11): 1071–7.
45. Caples SM, Gami AS, Somers VK. Obstructive sleep apnea. Ann Intern Med 2005; 142 (3): 187–97.
46. Curtis BM, O’Keefe Jr JH. Autonomic tone as a cardiovascular risk factor: the dangers of chronic fight or flight. Mayo Clin Proc 2002; 77 (1): 45–54.
47. Brook RD, Julius S. Autonomic imbalance, hypertension, and cardiovascular risk. Am J Hypertens 2000; 13 (6 Part 2): 112S–22S.
48. Usui K, Bradley TD, Spaak J et al. Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure. J Am Coll Cardiol 2005; 45: 2008–11.
49. Gilman MP, Floras JS, Usui K et al. Continuous positive airway pressure increases heart rate variability in heart failure patients with obstructive sleep apnoea. Clin Sci (Lond) 2008; 114: 243–9.
50. Prabhakar NR. Sleep apneas: an oxidative stress? Am J Respir Crit Care Med 2002; 165: 859–60.
51. Schulz R, Mahmoudi S, Hattar K et al. Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea: impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med 2000; 162: 566–70.
52. Suzuki YJ, Jain V, Park AM, Day RM. Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases. Free Radic Biol Med 2006; 40: 1683–92.
53. Lavie L. Obstructive sleep apnoea syndrome: an oxidative stress disorder. Sleep Med Rev 2003; 7: 35–51.
54. Meier-Ewert HK, Ridker PM, Rifai N et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol 2004; 43: 678–83.
55. Vgontzas AN, Papanicolaou DA, Bixler EO et al. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab 1997; 82: 1313–6.
56. Ohga E, Tomita T, Wada H et al. Effects of obstructive sleep apnea on circulating ICAM-1, IL-8, and MCP-1. J Appl Physiol 2003; 94: 179–84.
57. Minoguchi K, Yokoe T, Tazaki T et al. Silent brain infarction and platelet activation in obstructive sleep apnea. Am J Respir Crit Care Med 2007; 175: 612–7.
58. Svatikova A, Wolk R, Shamsuzzaman AS et al. Serum amyloid a in obstructive sleep apnea. Circulation 2003; 108: 1451–4.
59. Shamsuzzaman AS, Winnicki M, Lanfranchi P et al. Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation 2002; 105: 2462–4.
60. Larkin EK, Rosen CL, Kirchner HL et al. Variation of C-reactive protein levels in adolescents: association with sleepdisordered breathing and sleep duration. Circulation 2005; 111: 1978–84.
61. Punjabi NM, Beamer BA. C-reactive protein is associated with sleep disordered breathing independent of adiposity. Sleep 2007; 30: 29–34.
62. Dyugovskaya L, Lavie P, Lavie L. Increased adhesion molecules expression and production of reactive oxygen species in leukocytes of sleep apnea patients. Am J Respir Crit Care Med. 2002; 165: 934–9.
63. Dyugovskaya L, Lavie P, Lavie L. Lymphocyte activation as a possible measure of atherosclerotic risk in patients with sleep apnea. Ann N Y Acad Sci 2005; 1051: 340–50.
64. Drager LF, Polotsky VY, Lorenzi-Filho G. Obstructive sleep apnea: an emerging risk factor for atherosclerosis. Chest 2011; 140: 534–42.
65. Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol 2010; 7: 677–85.
66. Berger S, Lavie L. Endothelial progenitor cells in cardiovascular disease and hypoxia–potential implications to obstructive sleep apnea. Transl Res 2011; 158: 1–13.
67. Butt M, Khair OA, Dwivedi G et al. Myocardial perfusion by myocardial contrast echocardiography and endothelial dysfunction in obstructive sleep apnea. Hypertension 2011; 58: 417–24.
68. Drager LF, Bortolotto LA, Figueiredo AC et al. Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 2007; 176: 706–12.
69. Barcelo A, Pierola J, de la Pena M et al. Impaired circadian variation of platelet activity in patients with sleep apnea. Sleep Breath 2012; 16: 355–60.
70. Chin K, Ohi M, Kita H et al. Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 1996; 153: 1972–6.
71. Von Kanel R, Loredo JS, Ancoli-Israel S, Dimsdale JE. Association between sleep apnea severity and blood coagulability: treatment effects of nasal continuous positive airway pressure. Sleep Breath 2006; 10: 139–46.
72. Mehra R, Xu F, Babineau DC et al. Sleep-disordered breathing and prothrombotic biomarkers: crosssectional results of the Cleveland Family Study. Am J Respir Crit Care Med. 2010; 182: 826–33.
73. Minoguchi K, Yokoe T, Tazaki T et al. Silent brain infarction and platelet activation in obstructive sleep apnea. Am J Respir Crit Care Med 2007; 175: 612–7.
74. Arias MA, Garcia-Rio F, Alonso-Fernandez A et al. Obstructive sleep apnea syndrome affects left ventricular diastolic function: effects of nasal continuous positive airway pressure in men. Circulation 2005; 112 (3): 375–83.
75. Bradley TD, Floras JS. Sleep apnea and heart failure: Part I: obstructive sleep apnea. Circulation 2003; 107 (12): 1671–8.
76. Yaggi HK, Concato J, Kernan WN et al. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353 (19): 2034–41.
77. Gami AS, Pressman G, Caples SM et al. Association of atrial fibrillation and obstructive sleep apnea. Circulation 2004; 110 (4): 364–7.
78. Schulz R, Eisele HJ, Weissmann N, Seeger W. Pulmonary hypertension and sleep-related breathing disorders. Pneumologie 2005; 59 (4): 270–4.
79. Silverberg DS, Oksenberg A, Iaina A. Sleep-related breathing disorders as a major cause of essential hypertension: fact or fiction? Curr Opin Nephrol Hypertens 1998; 7: 353–7.
80. Fletcher EC, DeBehnke RD, Lovoi MS, Gorin AB. Undiagnosed sleep apnea in patients with essential hypertension. Ann Intern Med 1985; 103: 190–5.
81. Kales A, Bixler EO, Cadieux RJ et al. Sleep apnoea in a hypertensive population. Lancet 1984; 2: 1005–8.
82. Lavie P, Ben-Yosef R, Rubin AE. Prevalence of sleep apnea syndrome among patients with essential hypertension. Am Heart J 1984; 108: 373–6.
83. Vardan S, Dunsky MH, Hill NE et al. Systemic systolic hypertension in the elderly: correlation of hemodynamics, plasma volume, renin, aldosterone, urinary metanephrines and response to thiazide therapy. Am J Cardiol 1986; 58: 1030–4.
84. Williams AJ, Houston D, Finberg S et al. Sleep apnea syndrome and essential hypertension. Am J Cardiol 1985; 55: 1019–22.
85. Pratt-Ubunama MN, Nishizaka MK, Boedefeld RL et al. Plasma aldosterone is related to severity of obstructive sleep apnea in subjects with resistant hypertension. Chest 2007; 131 (2): 453–9.
86. Grote L, Hedner J, Peter JH. Sleep-related breathing disorder is an independent risk factor for uncontrolled hypertension. J Hypertens 2000; 18: 679–85.
87. Calhoun DA, Nishizaka MK, Zaman MA, Harding SM. Aldosterone excretion among subjects with resistant hypertension and symptoms of sleep apnea. Chest 2004; 125: 112–7.
88. Goodfriend TL, Calhoun DA. Resistant hypertension, obesity, sleep apnea, and aldosterone: theory and therapy. Hypertension 2004; 43: 518–24.
89. Rocchini AP, Katch VL, Grekin R. Role for aldosterone in blood pressure regulation of obese adolescents. Am J Cardiol 1986; 57 (8): 613–8.
90. Gonzaga CC, Gaddam KK, Ahmed MI et al. Severity of obstructive sleep apnea is related to aldosterone status in subjects with resistant hypertension. J Clin Sleep Med 2010; 6 (4): 363–8.
91. Fletcher EC, Bao G. The rat as a model of chronic recurrent episodic hypoxia and effect upon systemic blood pressure. Sleep 1996; 19(10 Suppl.): S210–2.
92. Hamilton GS, Solin P, Naughton MT. Obstructive sleep apnoea and cardiovascular disease. Intern Med J 2004; 34 (7): 420–6.
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104. Bazzano LA, Khan Z, Reynolds K, He J. Effect of treatment with nocturnal nasal continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea. Hypertension 2007; 50: 417–23.
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19. Logan AG, Perlikowski SM, Mente A et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens 2001; 19: 2271–7.
20. Roumelioti ME, Buysse DJ, Sanders MH et al. Sleep-disordered breathing and excessive daytime sleepiness in chronic kidney disease and hemodialysis. Clin J Am Soc Nephrol 2011; 6: 986–94.
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23. Gaddam K, Pimenta E, Thomas SJ et al. Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: a preliminary report. J Hum Hypertens 2010; 24: 532–7.
24. Su MC, Chiu KL, Ruttanaumpawan P et al. Lower body positive pressure increases upper airway collapsibility in healthy subjects. Respir Physiol Neurobiol 2008; 161: 306–12.
25. Redolfi S, Yumino D, Ruttanaumpawan P et al. Relationship between overnight rostral fluid shift and obstructive sleep apnea in nonobese men. Am J Respir Crit Care Med 2009; 179: 241–6.
26. Yumino D, Redolfi S, Ruttanaumpawan P et al. Nocturnal rostral fluid shift: a unifying concept for the pathogenesis of obstructive and central sleep apnea in men with heart failure. Circulation 2010; 121: 1598–605.
27. Elias RM, Bradley TD, Kasai T et al. Rostral overnight fluid shift in end-stage renal disease: relationship with obstructive sleep apnea. Nephrol Dial Transplant 2012; 27: 1569–73.
28. Friedman O, Bradley TD, Chan CT et al. Relationship between overnight rostral fluid shift and obstructive sleep apnea in drug-resistant hypertension. Hypertension 2010; 56: 1077–82.
29. Jafari B, Mohsenin V. Overnight rostral fluid shift in obstructive sleep apnea: does it affect the severity of sleep-disordered breathing? Chest 2011; 140: 991–7.
30. Redolfi S, Arnulf I, Pottier M et al. Effects of venous compression of the legs on overnight rostral fluid shift and obstructive sleep apnea. Respir Physiol Neurobiol 2011; 175: 390–3.
31. Redolfi S, Arnulf I, Pottier M et al. Attenuation of obstructive sleep apnea by compression stockings in subjects with venous insufficiency. Am J Respir Crit Care Med 2012; 184: 1062–6.
32. Tang SC, Lam B, Ku PP et al. Alleviation of sleep apnea in patients with chronic renal failure by nocturnal cycler-assisted peritoneal dialysis compared with conventional continuous ambulatory peritoneal dialysis. J Am Soc Nephrol 2006; 17: 2607–16.
33. Tang SC, Lam B, Lai AS et al. Improvement in sleep apnea during nocturnal peritoneal dialysis is associated with reduced airway congestion and better uremic clearance. Clin J Am Soc Nephrol 2009; 4: 410–8.
34. Hanly PJ, Pierratos A. Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis. N Engl J Med 2001; 344: 102–7.
35. Bucca CB, Brussino L, Battisti A et al. Diuretics in obstructive sleep apnea with diastolic heart failure. Chest 2007; 132: 440–6.
36. Narkiewicz K, Somers VK. Sympathetic nerve activity in obstructive sleep apnoea. Acta Physiol Scand 2003; 177 (3): 385–90.
37. Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 1995; 96 (4): 1897–904.
38. Narkiewicz K, van de Borne PJ, Cooley RL et al. Sympathetic activity in obese subjects with and without obstructive sleep apnea. Circulation 1998; 98 (8): 772–6.
39. Carlson JT, Hedner J, Elam M et al. Augmented resting sympathetic activity in awake patients with obstructive sleep apnea. Chest 1993; 103 (6): 1763–8.
40. Fletcher EC. Sympathetic over activity in the etiology of hypertension of obstructive sleep apnea. Sleep 2003; 26 (1): 15–9.
41. Phillips BG, Somers VK. Neural and humoral mechanisms mediating cardiovascular responses to obstructive sleep apnea. Respir Physiol 2000; 119 (2–3): 181–7.
42. Brooks D, Horner RL, Kozar LF et al. Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J Clin Invest 1997; 99: 106–9.
43. Spaak J, Egri ZJ, Kubo T et al. Muscle sympathetic nerve activity during wakefulness in heart failure patients with and without sleep apnea. Hypertension 2005; 46: 1327–32.
44. Narkiewicz K, Montano N, Cogliati C et al. Altered cardiovascular variability in obstructive sleep apnea. Circulation 1998; 98 (11): 1071–7.
45. Caples SM, Gami AS, Somers VK. Obstructive sleep apnea. Ann Intern Med 2005; 142 (3): 187–97.
46. Curtis BM, O’Keefe Jr JH. Autonomic tone as a cardiovascular risk factor: the dangers of chronic fight or flight. Mayo Clin Proc 2002; 77 (1): 45–54.
47. Brook RD, Julius S. Autonomic imbalance, hypertension, and cardiovascular risk. Am J Hypertens 2000; 13 (6 Part 2): 112S–22S.
48. Usui K, Bradley TD, Spaak J et al. Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure. J Am Coll Cardiol 2005; 45: 2008–11.
49. Gilman MP, Floras JS, Usui K et al. Continuous positive airway pressure increases heart rate variability in heart failure patients with obstructive sleep apnoea. Clin Sci (Lond) 2008; 114: 243–9.
50. Prabhakar NR. Sleep apneas: an oxidative stress? Am J Respir Crit Care Med 2002; 165: 859–60.
51. Schulz R, Mahmoudi S, Hattar K et al. Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea: impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med 2000; 162: 566–70.
52. Suzuki YJ, Jain V, Park AM, Day RM. Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases. Free Radic Biol Med 2006; 40: 1683–92.
53. Lavie L. Obstructive sleep apnoea syndrome: an oxidative stress disorder. Sleep Med Rev 2003; 7: 35–51.
54. Meier-Ewert HK, Ridker PM, Rifai N et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol 2004; 43: 678–83.
55. Vgontzas AN, Papanicolaou DA, Bixler EO et al. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab 1997; 82: 1313–6.
56. Ohga E, Tomita T, Wada H et al. Effects of obstructive sleep apnea on circulating ICAM-1, IL-8, and MCP-1. J Appl Physiol 2003; 94: 179–84.
57. Minoguchi K, Yokoe T, Tazaki T et al. Silent brain infarction and platelet activation in obstructive sleep apnea. Am J Respir Crit Care Med 2007; 175: 612–7.
58. Svatikova A, Wolk R, Shamsuzzaman AS et al. Serum amyloid a in obstructive sleep apnea. Circulation 2003; 108: 1451–4.
59. Shamsuzzaman AS, Winnicki M, Lanfranchi P et al. Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation 2002; 105: 2462–4.
60. Larkin EK, Rosen CL, Kirchner HL et al. Variation of C-reactive protein levels in adolescents: association with sleepdisordered breathing and sleep duration. Circulation 2005; 111: 1978–84.
61. Punjabi NM, Beamer BA. C-reactive protein is associated with sleep disordered breathing independent of adiposity. Sleep 2007; 30: 29–34.
62. Dyugovskaya L, Lavie P, Lavie L. Increased adhesion molecules expression and production of reactive oxygen species in leukocytes of sleep apnea patients. Am J Respir Crit Care Med. 2002; 165: 934–9.
63. Dyugovskaya L, Lavie P, Lavie L. Lymphocyte activation as a possible measure of atherosclerotic risk in patients with sleep apnea. Ann N Y Acad Sci 2005; 1051: 340–50.
64. Drager LF, Polotsky VY, Lorenzi-Filho G. Obstructive sleep apnea: an emerging risk factor for atherosclerosis. Chest 2011; 140: 534–42.
65. Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol 2010; 7: 677–85.
66. Berger S, Lavie L. Endothelial progenitor cells in cardiovascular disease and hypoxia–potential implications to obstructive sleep apnea. Transl Res 2011; 158: 1–13.
67. Butt M, Khair OA, Dwivedi G et al. Myocardial perfusion by myocardial contrast echocardiography and endothelial dysfunction in obstructive sleep apnea. Hypertension 2011; 58: 417–24.
68. Drager LF, Bortolotto LA, Figueiredo AC et al. Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 2007; 176: 706–12.
69. Barcelo A, Pierola J, de la Pena M et al. Impaired circadian variation of platelet activity in patients with sleep apnea. Sleep Breath 2012; 16: 355–60.
70. Chin K, Ohi M, Kita H et al. Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 1996; 153: 1972–6.
71. Von Kanel R, Loredo JS, Ancoli-Israel S, Dimsdale JE. Association between sleep apnea severity and blood coagulability: treatment effects of nasal continuous positive airway pressure. Sleep Breath 2006; 10: 139–46.
72. Mehra R, Xu F, Babineau DC et al. Sleep-disordered breathing and prothrombotic biomarkers: crosssectional results of the Cleveland Family Study. Am J Respir Crit Care Med. 2010; 182: 826–33.
73. Minoguchi K, Yokoe T, Tazaki T et al. Silent brain infarction and platelet activation in obstructive sleep apnea. Am J Respir Crit Care Med 2007; 175: 612–7.
74. Arias MA, Garcia-Rio F, Alonso-Fernandez A et al. Obstructive sleep apnea syndrome affects left ventricular diastolic function: effects of nasal continuous positive airway pressure in men. Circulation 2005; 112 (3): 375–83.
75. Bradley TD, Floras JS. Sleep apnea and heart failure: Part I: obstructive sleep apnea. Circulation 2003; 107 (12): 1671–8.
76. Yaggi HK, Concato J, Kernan WN et al. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353 (19): 2034–41.
77. Gami AS, Pressman G, Caples SM et al. Association of atrial fibrillation and obstructive sleep apnea. Circulation 2004; 110 (4): 364–7.
78. Schulz R, Eisele HJ, Weissmann N, Seeger W. Pulmonary hypertension and sleep-related breathing disorders. Pneumologie 2005; 59 (4): 270–4.
79. Silverberg DS, Oksenberg A, Iaina A. Sleep-related breathing disorders as a major cause of essential hypertension: fact or fiction? Curr Opin Nephrol Hypertens 1998; 7: 353–7.
80. Fletcher EC, DeBehnke RD, Lovoi MS, Gorin AB. Undiagnosed sleep apnea in patients with essential hypertension. Ann Intern Med 1985; 103: 190–5.
81. Kales A, Bixler EO, Cadieux RJ et al. Sleep apnoea in a hypertensive population. Lancet 1984; 2: 1005–8.
82. Lavie P, Ben-Yosef R, Rubin AE. Prevalence of sleep apnea syndrome among patients with essential hypertension. Am Heart J 1984; 108: 373–6.
83. Vardan S, Dunsky MH, Hill NE et al. Systemic systolic hypertension in the elderly: correlation of hemodynamics, plasma volume, renin, aldosterone, urinary metanephrines and response to thiazide therapy. Am J Cardiol 1986; 58: 1030–4.
84. Williams AJ, Houston D, Finberg S et al. Sleep apnea syndrome and essential hypertension. Am J Cardiol 1985; 55: 1019–22.
85. Pratt-Ubunama MN, Nishizaka MK, Boedefeld RL et al. Plasma aldosterone is related to severity of obstructive sleep apnea in subjects with resistant hypertension. Chest 2007; 131 (2): 453–9.
86. Grote L, Hedner J, Peter JH. Sleep-related breathing disorder is an independent risk factor for uncontrolled hypertension. J Hypertens 2000; 18: 679–85.
87. Calhoun DA, Nishizaka MK, Zaman MA, Harding SM. Aldosterone excretion among subjects with resistant hypertension and symptoms of sleep apnea. Chest 2004; 125: 112–7.
88. Goodfriend TL, Calhoun DA. Resistant hypertension, obesity, sleep apnea, and aldosterone: theory and therapy. Hypertension 2004; 43: 518–24.
89. Rocchini AP, Katch VL, Grekin R. Role for aldosterone in blood pressure regulation of obese adolescents. Am J Cardiol 1986; 57 (8): 613–8.
90. Gonzaga CC, Gaddam KK, Ahmed MI et al. Severity of obstructive sleep apnea is related to aldosterone status in subjects with resistant hypertension. J Clin Sleep Med 2010; 6 (4): 363–8.
91. Fletcher EC, Bao G. The rat as a model of chronic recurrent episodic hypoxia and effect upon systemic blood pressure. Sleep 1996; 19(10 Suppl.): S210–2.
92. Hamilton GS, Solin P, Naughton MT. Obstructive sleep apnoea and cardiovascular disease. Intern Med J 2004; 34 (7): 420–6.
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107. Pepin JL, Tamisier R, Barone-Rochette G et al. Сomparison of continuous positive airway pressure and valsartan in hypertensive patients with sleep apnea. Am J Respir Crit Care Med 2010; 182 (7): 954–60.
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102. Bloch MJ, Basile J. Short-term treatment of sleep apnea with nocturnal continuous positive airway pressure does not improve blood pressure in patients with well controlled hypertension. J Clin Hypertens (Greenwich) 2006; 8: 673–5.
103. Haentjens P, van Meerhaeghe A, Moscariello A et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007; 167: 757–64.
104. Bazzano LA, Khan Z, Reynolds K, He J. Effect of treatment with nocturnal nasal continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea. Hypertension 2007; 50: 417–23.
105. Alajmi M, Mulgrew AT, Fox J et al. Impact of continuous positive airway pressure therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomized controlled trials. Lung 2007; 185: 67–72.
106. Iftikhara IH, Valentineb CW, Bittencourtc LRA et al. Magalangk Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertension 2014; 32 (Issue 12): 2341–50.
107. Pepin JL, Tamisier R, Barone-Rochette G et al. Сomparison of continuous positive airway pressure and valsartan in hypertensive patients with sleep apnea. Am J Respir Crit Care Med 2010; 182 (7): 954–60.
Авторы
А.Ю.Литвин*, О.О.Михайлова, Е.М.Елфимова, Т.Д.Бугаев, И.Е.Чазова
Институт клинической кардиологии им. А.Л.Мясникова ФГБУ Российский кардиологический научно-производственный комплекс Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
*alelitvin@yandex.ru
Институт клинической кардиологии им. А.Л.Мясникова ФГБУ Российский кардиологический научно-производственный комплекс Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
*alelitvin@yandex.ru
________________________________________________
A.Yu.Litvin*, O.O.Mikhailova, E.M.Elfimova, T.D.Bugaev, I.E.Chazova
A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*alelitvin@yandex.ru
A.L.Myasnikov Institute of Clinical Cardiology Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*alelitvin@yandex.ru
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