Comorbid obstructive sleep apnoea and chronic obstructive pulmonary disease and the risk of cardiovascular disease.

Comorbid obstructive sleep apnoea and chronic obstructive pulmonary disease and the risk of cardiovascular disease. J Thorac Dis. 2018 Dec;10(Suppl 34):S4253-S4261 Authors: McNicholas WT Abstract Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea (OSA) syndrome are both highly prevalent, affecting at least 10% of the general adult population, and each has been independently associated with an increased risk of cardiovascular disease. The presence of both disorders together, commonly referred to as the overlap syndrome, is also highly prevalent, although various clinical and pathophysiological factors associated with COPD may increase or decrease the likelihood of OSA. Lung hyperinflation reduces the likelihood of obstructive apnoea, whereas right heart failure increases the likelihood as a result of rostral fluid shift causing upper airway narrowing in the supine position while asleep. Furthermore, upper airway inflammation associated with OSA may aggravate lower airway inflammation in COPD. The proposed mechanisms of cardiovascular disease in each disorder are similar and include systemic inflammation, oxidative stress, and sympathetic excitation. Thus, one could expect that the prevalence of co-morbid cardiovascular disease would be higher in the overlap syndrome but, with the exception of pulmonary hypertension, there are few published reports that have explored this aspect in depth. Hypoxia is more pronounc...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research