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      Translational approaches to understanding metabolic dysfunction and cardiovascular consequences of obstructive sleep apnea

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          Abstract

          Obstructive sleep apnea (OSA) is known to be independently associated with several cardiovascular diseases including hypertension, myocardial infarction, and stroke. To determine how OSA can increase cardiovascular risk, animal models have been developed to explore the underlying mechanisms and the cellular and end-organ targets of the predominant pathophysiological disturbance in OSA–intermittent hypoxia. Despite several limitations in translating data from animal models to the clinical arena, significant progress has been made in our understanding of how OSA confers increased cardiovascular risk. It is clear now that the hypoxic stress associated with OSA can elicit a broad spectrum of pathological systemic events including sympathetic activation, systemic inflammation, impaired glucose and lipid metabolism, and endothelial dysfunction, among others. This review provides an update of the basic, clinical, and translational advances in our understanding of the metabolic dysfunction and cardiovascular consequences of OSA and highlights the most recent findings and perspectives in the field.

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          Author and article information

          Journal
          Am J Physiol Heart Circ Physiol
          Am. J. Physiol. Heart Circ. Physiol
          ajpheart
          ajpheart
          AJPHEART
          American Journal of Physiology - Heart and Circulatory Physiology
          American Physiological Society (Bethesda, MD )
          0363-6135
          1522-1539
          31 July 2015
          October 2015
          : 309
          : 7
          : H1101-H1111
          Affiliations
          [1] 1Hypertension Unit, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil;
          [2] 2Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo, Brazil;
          [3] 3Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;
          [4] 4Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania;
          [5] 5Department of Physiology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil;
          [6] 6Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil; and
          [7] 7Department of Physiology, School of Medicine of Ribeirao Preto, University of São Paulo, São Paulo, Brazil
          Author notes
          Address for reprint requests and other correspondence: L. F. Drager, Hypertension Unit-Heart Inst. (InCor), Univ. of São Paulo Medical School, Avenida Dr Eneas Carvalho de Aguiar, 44, CEP 05403-900, São Paulo, Brazil (e-mail: luciano.drager@ 123456incor.usp.br ).
          Article
          PMC4816265 PMC4816265 4816265 H-00094-2015
          10.1152/ajpheart.00094.2015
          4816265
          26232233
          af629ad7-6f9c-4e08-875d-787f769b89bb
          Copyright © 2015 the American Physiological Society
          History
          : 5 February 2015
          : 22 July 2015
          Funding
          Funded by: São Paulo Research Foundation (FAPESP)
          Award ID: 2012/02953-2
          Award ID: 2013/06077-5
          Categories
          Review

          translational medicine,intermittent hypoxia,sleep apnea,cardiovascular disease

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