Sleep-Disordered Breathing-a Real Therapeutic Target for Hypertension, Pulmonary Hypertension, Ischemic Heart Disease, and Chronic Heart Failure?

Sleep-Disordered Breathing-a Real Therapeutic Target for Hypertension, Pulmonary Hypertension, Ischemic Heart Disease, and Chronic Heart Failure? J Nippon Med Sch. 2018;85(2):70-77 Authors: Nakamoto T Abstract Sleep-disordered breathing (SDB) is a risk factor for cardiovascular disease including acute coronary syndrome and acute myocardial infarction, and treating SDB prevents their development and recurrence and improves a patient's prognosis. Therefore, SDB is considered a therapeutic target for cardiovascular disease. In 2010, the Japanese Circulation Society published guidelines for the diagnosis and treatment of SDB in patients with cardiovascular disease. However, therapeutic intervention for patients with SDB was recently reported not to suppress the development or deterioration of cardiovascular disease in three middle- to large-sized randomized clinical trials: the SERVE-HF trial, which examined the effects of adaptive servo-ventilation (ASV) on patients with chronic heart failure (CHF) and central sleep apnea; the CAT-HF trial, which examined the effects of ASV therapy on patients with CHF after acute deterioration; and the SAVE study, which examined the secondary preventive effect of continuous positive airway pressure (CPAP) on patients with ischemic heart disease who had mild to moderate obstructive sleep apnea. These studies caused hesitation among clinicians to proactively treat SDB by ASV or CPAP therapy. The present ...
Source: Journal of Nippon Medical School - Category: Universities & Medical Training Authors: Tags: J Nippon Med Sch Source Type: research