This article is aimed at addressing the current state of the art in epidemiology, pathophysiology, diagnostic procedures and treatment options for appropriate management of obstructive sleep apnea (OSA) in cardiovascular (particularly hypertensive) patients, as well as for the management of cardiovascular diseases (particularly arterial hypertension) in OSA patients. The present document is the result of the work done by a panel of experts participating in the European Union COST (COoperation in Scientific and Technological research) ACTION B26 on OSA, with the endorsement of the European Respiratory Society (ERS) and the European Society of Hypertension (ESH). These recommendations are particularly aimed at reminding cardiovascular experts to consider the occurrence of sleep-related breathing disorders in patients with high blood pressure. They are at the same time aimed at reminding respiration experts to consider the occurrence of hypertension in patients with respiratory problems at night.
aDepartment of Clinical Medicine and Prevention, University of Milano-Bicocca
bDepartment of Cardiology, S. Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan, Italy
cSleep Disorders Centre, Sahlgrenska University Hospital, Gothenburg, Sweden
dDepartment of Medicine, Pneumology, Physiology and Nutrition (DIMPEFINU), University of Palermo, Palermo, Italy
eDepartment of Respiratory Medicine and Tuberculosis, Faculty of Medicine, L. Pasteur Teaching Hospital, P.J. Safarik University, Kosice, Slovakia
fGrenoble University Hospital, CHU Michallon, Grenoble, France
gRoyal Infirmary of Edinburgh, Edinburgh, UK
hDepartment of Neurology, University Hospital (Inselspital), Bern, Switzerland
iDepartment of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
jRespiratory Sleep Disorders Unit, St Vincent's University Hospital, Conway Research Institute, University College, Dublin, Ireland
Correspondence to Professor Gianfranco Parati, MD, FESC, S. Luca Hospital, Istituto Auxologico Italiano, Piazzale Brescia 20, Milan 20159, Italy. Tel: +39 02 619 112 949; fax: +39 02 619 112 956; e-mail: firstname.lastname@example.org
Abbreviations: ABPM, ambulatory blood pressure monitoring; AHI, apnea hypopnea index; AV, atrioventricular; BP, blood pressure; CHF, congestive heart failure; CPAP, continuous positive airway pressure; CSA, central sleep apnea; CVD, cardiovascular diseases; DBP, diastolic blood pressure; IL-8, interleukine-8; NF-κB, nuclear factor kappa-light-chain-enhancer of activated B cells; OSA, obstructive sleep apnea; OSAS, obstructive sleep apnea syndrome; RAAS, renin–angiotensin–aldosterone system; SBP, systolic blood pressure; SRBD, sleep-related breathing disorders; SVES, supraventricular extrasystoles; TNF-α, tumor necrosis factor-α
Received 27 December, 2011
Accepted 30 December, 2011
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