轻度睡眠呼吸暂停可能增加心脏患病危险—丁香园

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Mild Sleep Apnea May Raise Heart Risk
——Even Sleep Apnea Patients Who Don't Feel Drowsy in Daytime Are at Risk for Heart Disease

Oct.24, 2008 -- Sleep apnea -- even if it is so mild that people have nodaytime drowsiness -- may increase the risk of cardiovascular disease,a study shows.

The study, published in the American Journal ofRespiratory and Critical Care Medicine, compared patients with mildsleep apnea to a comparison group that didn't have sleep apnea. Therewere 64 participants with mild sleep apnea and 15 participants withoutsleep apnea.

To compare the risk for heart disease, researcherstested endothelial function, which is how well the cells in the liningof the blood vessels work, and artery stiffness. Endothelialdysfunction and arterial stiffness are involved in developingatherosclerosis, or hardening of the arteries. Moderate to severe sleepapnea has already been linked to increased artery stiffness,endothelial dysfunction, and high blood pressure.

MalcolmKohler, MD, from the Oxford Centre for Respiratory Medicine in England,and colleagues found that patients with mild sleep apnea had worseendothelial function and greater arterial stiffness than the comparisongroup without sleep apnea.

Researchers also tested bloodpressure, another way to gauge cardiovascular disease risk. The groupstested similarly on blood pressure.

The researchers write that"although this was not associated with significantly increased bloodpressure, the findings of this study suggest that patients withminimally symptomatic OSA [obstructive sleep apnea] are at increasedcardiovascular risk, as has been demonstrated in more severe disease."

"Itwas previously known that people with OSA (obstructive sleep apnea)severe enough to affect their daytime alertness and manifest in otherways are at increased risk of cardiovascular disease, but this findingsuggests that many more people -- some of whom may be completelyunaware that they even have OSA -- are at risk than previouslythought," Kohler says in a news release.

In an accompanyingeditorial, Geraldo Lorenzi-Filho MD, PhD, points out that just one infive patients with sleep apnea complains of drowsiness during the day."It is now recognized that OSA triggers a cascade of biologicalreactions, including increased sympathetic activity, systemicinflammation, oxidative stress, and metabolic alterations that arepotentially harmful to the cardiovascular system," he writes in theeditorial.

Kohler and colleagues are now investigating theeffects of continuous positive airway pressure (CPAP) therapy onarterial stiffness and endothelial function in patients with sleepapnea.

http://www.webmd.com/sleep-disorders/sleep-apnea/news/20081024/mild-sleep-apnea-may-up-heart-risk
发这篇文章的目的是：我们在麻醉术前评估的时候一旦晕倒这种患者，一定要考虑到患者心脏的问题。