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Sleep apnoea, hypertension and vascular disease: where are we now?

^* Dept of Pulmonology, Centre for Sleep Monitoring and Home Ventilation, University Hospital Gasthuisberg Leuven, Belgium, ^# Sleep Laboratory, Pulmonary Medicine, Sahlgrenska University Hospital Gothenburg, Sweden, ^¶ Participants of working group 2 are listed in the Appendix.

CORRESPONDENCE: B. Buyse, Dept of Pulmonology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium, Fax: 32 16346803. E-mail: Bertien.Buyse{at}uz.kuleuven.ac.be

The objective of the present article was to explore the relationship between obstructive sleep apnoea (OSA) and hypertension (HT) and/or arterial vascular disease (VD), including stroke and ischaemic coronary disease.

Epidemiological and interventional studies on these relationships provide compelling evidence that OSA is causally related to HT. The causal relationship between OSA and VD other than HT has not been firmly established.

A number of pathophysiological mechanisms that could potentially provide a causal link between obstructive sleep apnoea and hypertension, as well as vascular disease, have been identified. Available data on such mechanisms include sustained daytime sympathetic activation, oxidative stress, promotion of vascular inflammation and endothelial dysfunction.

KEYWORDS: Free radicals, hypertension, inflammation, sleep apnoea, sympathetic, vascular disease