RESUMO
Cardiovascular and cerebrovascular diseases are the most common diseases in industrialized societies. The main objectives of this article were to summarize the physiological effects of sleep apnea on the circulatory system and to review how treatment of this condition influences cardiovascular disease. Acute sleep apnea has a number of hemodynamic consequences, such as pulmonary and systemic hypertension, increased ventricular afterload and reduced cardiac output, all of which result from sympathetic stimulation, arousal, alterations in intrathoracic pressure, hypoxia and hypercapnia. When chronic, sleep apnea-hypopnea syndrome is associated with systemic hypertension, ischemic heart disease, congestive heart failure, and Cheyne-Stokes respiration in patients with congestive heart failure. Nocturnal treatment with continuous positive airway pressure decreases both the number of central apneic episodes and blood pressure in patients with sleep apnea-hypopnea syndrome and arterial hypertension.
Assuntos
Cardiopatias/etiologia , Síndromes da Apneia do Sono/complicações , Doenças Cardiovasculares/etiologia , HumanosRESUMO
Las enfermedades cardiovasculares y cerebrovasculares son las más comunes en la sociedad industrial. Los objetivos principales de este trabajo son revisar las consecuencias fisiológicas de la apnea del sueño en el sistema circulatorio y revisar los efectos del tratamiento de esta alteración sobre las enfermedades cardiovasculares. Las apneas durante el sueño producen de forma aguda una serie de consecuencias hemodinámicas que incluyen: hipertensión pulmonar y sistémica, incremento de la poscarga ventricular y disminución del gasto cardiaco, fenómenos todos ellos resultado de la estimulación simpática, del arousal, de las alteraciones en la presión intratorácica y de la hipoxia e hipercapnia. De forma crónica, el síndrome de apneas-hipopneas durante el sueño (SAHS) se ha relacionado con hipertensión arterial sistémica diurna, cardiopatía isquémica, insuficiencia cardiaca congestiva y respiración de Cheyne-Stokes en el fracaso cardiaco congestivo. Se ha observado que el tratamiento con presión positiva continua (CPAP) nasal nocturna sobre la vía aérea superior disminuye el número de apneas centrales y también reduce los valores de presión arterial en pacientes con SAHS e hipertensión arterial
Cardiovascular and cerebrovascular diseases are the most common diseases in industrialized societies. The main objectives of this article were to summarize the physiological effects of sleep apnea on the circulatory system and to review how treatment of this condition influences cardiovascular disease. Acute sleep apnea has a number of hemodynamic consequences, such as pulmonary and systemic hypertension, increased ventricular afterload and reduced cardiac output, all of which result from sympathetic stimulation, arousal, alterations in intrathoracic pressure, hypoxia and hypercapnia. When chronic, sleep apnea-hypopnea syndrome is associated with systemic hypertension, ischemic heart disease, congestive heart failure, and Cheyne-Stokes respiration in patients with congestive heart failure. Nocturnal treatment with continuous positive airway pressure decreases both the number of central apneic episodes and blood pressure in patients with sleep apnea-hypopnea syndrome and arterial hypertension
