Obstructive Sleep Apnea and Coronary Artery Disease

Obstructive apneas during sleep lead to a sequence of events that independently, or in concert with other recognized risk factors, appear to induce harmful effects on vascular structure and function. Although the epidemiologic support for a causal relationship between obstructive sleep apnea (OSA) and coronary artery disease (CAD) is rapidly increasing, data is still not fully conclusive. In general, the relationship is stronger in clinical cohorts, compared with in the general population, suggesting that comorbid OSA may provide an additive or synergistic risk factor for development of CAD in obese, hypertensive, smoking, or hyperlipidemic subjects. Recognition of the adverse impact of OSA on vascular disease may open a perspective of new primary and secondary prevention models for CAD, involving identification and elimination of the sleep and breathing disorder.