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Obstructive sleep apnea and cardiovascular events in elderly patients

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EXPERT REVIEW OF RESPIRATORY MEDICINE
卷 16, 期 2, 页码 197-210

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TAYLOR & FRANCIS LTD
DOI: 10.1080/17476348.2022.2030225

关键词

Sleep; Apnea; cardiovascular; elderly; Coronary Heart Disease; Stroke

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This article reviews the association between obstructive sleep apnea (OSA) and cardiovascular events (CVE) in the elderly, as well as the impact of continuous positive airway pressure (CPAP) treatment on CVE. Although the positive association between OSA and cardiovascular disease in the elderly has been established, the role of OSA in certain cardiovascular events remains controversial.
Introduction In recent decades, life expectancy has increased considerably. The cardiovascular effects of Obstructive Sleep Apnea (OSA) in the elderly lead to patient disability and high resource consumption. Intermittent nocturnal hypoxia leads to hemodynamic stress and adrenergic activation, which promotes cardiovascular disease. However, chronic intermittent hypoxia may protect elderly patients from cardiovascular events (CVE) due to biological adaptation. Areas covered OSA patients are at increased risk of cardiovascular events. The severity of OSA increases cardiovascular risk, and this association also exists in the elderly. This article reviews the association between OSA, CPAP treatment, and CVE, particularly stroke and coronary heart disease (CHD), in the elderly. MEDLINE and the Cochrane Collaboration databases were searched from inception to July 2021. Expert Commentary Although a positive association between OSA and the incidence of cardiovascular disease in the elderly has been established, the role of sleep apnea in certain cardiovascular events remains controversial. Most authors agree that untreated OSA is a risk factor for stroke or worse stroke prognosis. However, the association between OSA and CHD is usually less pronounced than between OSA and stroke, especially in the elderly.

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