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Síndrome da apneia obstrutiva do sono em doentes com hipertensão arterial : benefícios do tratamento com CPAP
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Resumo(s)
A síndrome da Apneia Obstrutiva do sono (SAOS) é uma patologia de origem multifatorial e frequentemente subdiagnosticada, motivo pelo qual culmina em numerosas complicações, as quais poderiam ser atenuadas através do reconhecimento e tratamento precoces. Enquanto distúrbio respiratório caracteriza-se por episódios de apneias e hipopneias secundárias ao colapso intermitente da via aérea, o que conduz a microdespertares e à fragmentação do sono. Devido aos mecanismos fisiopatológicos envolvidos, além da diminuição evidente da qualidade de vida, estes doentes apresentam um risco cardiovascular (CV) aumentado, o que se traduz inevitavelmente em taxas de morbilidade e mortalidade significativas. Entre as complicações que contribuem para o aumento do risco CV encontra-se a hipertensão arterial (HTA), a qual apresenta uma excelente correlação em termos de gravidade com a SAOS. Como a SAOS é prevalente na população de hipertensos, o seu despiste torna-se imperativo na medida em que o tratamento do distúrbio respiratório permite que haja um melhor controlo tensional e, desta forma, previne as lesões de órgão-alvo típicas da HTA. Desta forma, o objetivo passa pelo tratamento combinado de ambas as patologias. É neste sentido que o tratamento com continuous positive airway pressure (CPAP) se revela de extrema importância no que concerne aos endpoints CV, nomeadamente na população de hipertensos, dado que numerosos estudos comprovam os benefícios obtidos ao nível da pressão arterial (PA).
Obstructive sleep apnea (OSA) is a multifactorial underdiagnosed disease, which leads to numerous complications that could be attenuated through early recognition and treatment. As a respiratory disorder, it is characterized by episodes of apnea and hypopnea secondary to intermittent collapse of the airway during sleep, leading to intermittent hypoxia and sleep fragmentation. Due to the pathophysiological mechanisms involved, in addition to the evident decrease in quality of life, these patients have an increased cardiovascular risk (CV), which inevitably results in significant morbidity and mortality rates. Among the complications that contribute to increased CV risk is hypertension, which has an excellent correlation in terms of severity with OSA. OSA has high prevalence in the hypertensive population, so its screening becomes crucial as the treatment of the respiratory disorder allows for a better tension control and, thus, prevents the target organ lesions typical of hypertension. With this in mind, the goal is the combined treatment of both disorders. That’s why CPAP is extremely important with regard to CV endpoints, particularly in the hypertensive population, since numerous studies have proven the benefits obtained at the blood pressure control.
Obstructive sleep apnea (OSA) is a multifactorial underdiagnosed disease, which leads to numerous complications that could be attenuated through early recognition and treatment. As a respiratory disorder, it is characterized by episodes of apnea and hypopnea secondary to intermittent collapse of the airway during sleep, leading to intermittent hypoxia and sleep fragmentation. Due to the pathophysiological mechanisms involved, in addition to the evident decrease in quality of life, these patients have an increased cardiovascular risk (CV), which inevitably results in significant morbidity and mortality rates. Among the complications that contribute to increased CV risk is hypertension, which has an excellent correlation in terms of severity with OSA. OSA has high prevalence in the hypertensive population, so its screening becomes crucial as the treatment of the respiratory disorder allows for a better tension control and, thus, prevents the target organ lesions typical of hypertension. With this in mind, the goal is the combined treatment of both disorders. That’s why CPAP is extremely important with regard to CV endpoints, particularly in the hypertensive population, since numerous studies have proven the benefits obtained at the blood pressure control.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Apneia do sono Hipertensão arterial Dispositivo de pressão contínua da via aérea Otorrinolaringologia