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Authors
Abstract(s)
A doença cardiovascular é uma das principais causas de mortalidade no mundo. Vários
aspectos contribuem para a génese da aterosclerose e suas complicações clínicas como:
tabagismo, níveis elevados de colesterol de lipoproteína de baixa densidade, baixos níveis de
colesterol de lipoproteína de alta densidade, diabetes, hipertensão arterial, história familiar,
obesidade, sedentarismo e ingestão de álcool. Além desses factores tem sido observado
recentemente um aumento da taxa de mortalidade cardiovascular em doentes com Síndrome
de Apneia Obstrutiva do Sono.
Existe uma evidência entre a Síndrome de Apneia Obstrutiva do Sono e as doenças
cardiovasculares, nomeadamente hipertensão arterial, doença cardíaca isquémica, acidente
vascular cerebral, insuficiência cardíaca, fibrilhação auricular e morte súbita cardíaca.
A patogénese da doença cardiovascular na Síndrome de Apneia Obstrutiva do Sono não
está completamente esclarecida, mas provavelmente existe uma multiplicidade de factores,
envolvendo uma série de mecanismos diversos, incluindo a hiperactividade do sistema
nervoso simpático, a activação das vias inflamatórias, a disfunção endotelial, as alterações da
coagulação, a disfunção metabólica e por fim a resistência à insulina e a alteração do
metabolismo lipídico.
Estudos efectuados em grande escala, definiram a população de doentes com Síndrome de
Apneia Obstrutiva do Sono, sendo necessário um controlo adequado para evitar factores
confundidores. Tais estudos têm por objectivo avaliar as interacções entre os diferentes
mecanismos básicos que actuam na Síndrome de Apneia Obstrutiva do Sono e na doença
cardiovascular, e as interacções com outros distúrbios, tais como a obesidade, a diabetes e a
dislipidémia.
Neste trabalho foi analisada a relação entre a Síndrome de Apneia Obstrutiva do Sono e o
risco cardiovascular, bem como o impacto da terapêutica, com pressão positiva contínua na via aérea, na redução do risco cardiovascular.
Concluíu-se que indivíduos com esta síndrome apresentam maior risco de desenvolver
doença cardiovascular e que a terapêutica com pressão positiva contínua na via aérea poderá
vir a reduzir este risco.
Cardiovascular disease is a major cause of mortality worldwide. Several aspects contribute to the genesis of atherosclerosis and its clinical complications such as smoking, high lowdensity lipoprotein cholesterol, low high-density lipoprotein cholesterol, diabetes, systemic arterial hypertension, family history, obesity, sedentary lifestyle and intake of alcohol. Besides these factors we have recently observed an increased rate of cardiovascular mortality in patients with Obstructive Sleep Apnoea Syndrome. There is growing evidence of Obstructive Sleep Apnoea Syndrome determining cardiovascular diseases, including hypertension, ischaemic heart disease, stroke, heart failure, atrial fibrillation and cardiac sudden death. The pathogenesis of cardiovascular disease in this syndrome is not completely understood, but likely to be multifactorial, involving a diverse range of different mechanisms including sympathetic nervous system overactivity, activation of inflammatory pathways, endothelial dysfunction, abnormal coagulation, metabolic dysregulation, insulin resistance and disordered lipid metabolism. Large scale studies have defined a population of patients with Obstructive Sleep Apnoea Syndrome, and controlling is needed to avoid confounding factors. Such studies aim to assess the interactions between different basic mechanisms operating in this syndrome and in cardiovascular disease, as well as interactions with other disorders such as obesity, diabetes and dyslipidaemia. This study examined the relationship between Obstructive Sleep Apnoea Syndrome and cardiovascular risk, as well as the impact of therapy with continuous positive airway pressure, in reducing cardiovascular risk. It is shown that individuals with this syndrome have a higher risk of developing cardiovascular disease and treatment with continuous positive airway pressure may reduce this risk.
Cardiovascular disease is a major cause of mortality worldwide. Several aspects contribute to the genesis of atherosclerosis and its clinical complications such as smoking, high lowdensity lipoprotein cholesterol, low high-density lipoprotein cholesterol, diabetes, systemic arterial hypertension, family history, obesity, sedentary lifestyle and intake of alcohol. Besides these factors we have recently observed an increased rate of cardiovascular mortality in patients with Obstructive Sleep Apnoea Syndrome. There is growing evidence of Obstructive Sleep Apnoea Syndrome determining cardiovascular diseases, including hypertension, ischaemic heart disease, stroke, heart failure, atrial fibrillation and cardiac sudden death. The pathogenesis of cardiovascular disease in this syndrome is not completely understood, but likely to be multifactorial, involving a diverse range of different mechanisms including sympathetic nervous system overactivity, activation of inflammatory pathways, endothelial dysfunction, abnormal coagulation, metabolic dysregulation, insulin resistance and disordered lipid metabolism. Large scale studies have defined a population of patients with Obstructive Sleep Apnoea Syndrome, and controlling is needed to avoid confounding factors. Such studies aim to assess the interactions between different basic mechanisms operating in this syndrome and in cardiovascular disease, as well as interactions with other disorders such as obesity, diabetes and dyslipidaemia. This study examined the relationship between Obstructive Sleep Apnoea Syndrome and cardiovascular risk, as well as the impact of therapy with continuous positive airway pressure, in reducing cardiovascular risk. It is shown that individuals with this syndrome have a higher risk of developing cardiovascular disease and treatment with continuous positive airway pressure may reduce this risk.
Description
Keywords
Síndrome de apneia obstrutiva do sono Síndrome de apneia obstrutiva do sono - Doença cardiovascular Hipoxia intermitente Síndrome de apneia obstrutiva do sono - Síndrome metabólica
Pedagogical Context
Citation
Publisher
Universidade da Beira Interior