The DOI matches its Crossref record; 87 of the 87 references it cites were found in a registry or an index.
Obstructive Sleep Apnea
Open accessAbstract
Obstructive sleep apnea (OSA) is an underdiagnosed condition characterized by recurrent episodes of obstruction of the upper airway leading to sleep fragmentation and intermittent hypoxia during sleep. Obesity predisposes to OSA, and the prevalence of OSA is increasing worldwide because of the ongoing epidemic of obesity. Recent evidence has shown that surrogate markers of cardiovascular risk, including sympathetic activation, systemic inflammation, and endothelial dysfunction, are significantly increased in obese patients with OSA versus those without OSA, suggesting that OSA is not simply an epiphenomenon of obesity. Moreover, findings from animal models and patients with OSA show that intermittent hypoxia exacerbates the metabolic dysfunction of obesity, augmenting insulin resistance and nonalcoholic fatty liver disease. In patients with the metabolic syndrome, the prevalence of moderate to severe OSA is very high (∼60%). In this population, OSA is independently associated with increased glucose and triglyceride levels as well as markers of inflammation, arterial stiffness, and atherosclerosis. A recent randomized, controlled, crossover study showed that effective treatment of OSA with continuous positive airway pressure for 3 months significantly reduced several components of the metabolic syndrome, including blood pressure, triglyceride levels, and visceral fat. Finally, several cohort studies have consistently shown that OSA is associated with increased cardiovascular mortality, independent of obesity. Taken together, these results support the concept that OSA exacerbates the cardiometabolic risk attributed to obesity and the metabolic syndrome. Recognition and treatment of OSA may decrease the cardiovascular risk in obese patients.
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“where an increased risk of cardiopulmonary disease and mortality has been established (true positive)432–434”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [432]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Central adiposity is linked to the development of both OSA and the metabolic syndrome, with both sharing similar pathophysiological features (eg, systemic inflammation, endothelial dysfunction).47”
From Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2021) · cites this paper as [47]
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“In addition, intermittent hypoxia of adipose tissue, sympathetic activation, induction of adipocytokines, and oxidative stress may promote the development of metabolic risk factors.47”
From Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2021) · cites this paper as [47]
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Citations
Cites
1 retracted
RETRACTED: CPAP for the Metabolic Syndrome in Patients with Obstructive Sleep Apnea
Sharma, S. K., Agrawal, S., Damodaran, D., Sreenivas, V., Kadhiravan, T., Ramakrishnan, L., Jagia, P., & Kumar, A. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1103944 · Cited by 366
RetractedGrundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., Gordon, D. J., Krauss, R. M., Savage, P. J., Smith, S. C., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.169404 · Cited by 11,961
The Occurrence of Sleep-Disordered Breathing among Middle-Aged Adults
Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., & Badr, S. (1993) · New England Journal of Medicine · doi:10.1056/nejm199304293281704 · Cited by 10,183
Marin, J. M., Carrizo, S. J., Vicente, E., & Agusti, A. G. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71141-7 · Cited by 4,678
Increased Prevalence of Sleep-Disordered Breathing in Adults
Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kws342 · Cited by 4,618
McNicholas, W. T., Strohl, K. P., White, D. P., Levy, P. A., Schmidt, W., Wheatley, J. R., Redline, S. S., Carley, D. W., Buysse, D. J., Young, T. B., et al. (1999) · PubMed · Cited by 3,665
Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up of the Wisconsin Sleep Cohort
(2008) · Sleep · doi:10.5665/sleep/31.8.1071 · Cited by 1,853
Gottlieb, D. J., Yenokyan, G., Newman, A. B., O'Connor, G. T., Punjabi, N. M., Quan, S. F., Redline, S., Resnick, H. E., Tong, E. K., Diener-West, M., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.901801 · Cited by 1,551
Collop, N. A., Anderson, W. M., Boehlecke, B., Claman, D., Goldberg, R., Gottlieb, D. J., Hudgel, D., Sateia, M., Schwab, R., & Portable Monitoring Task Force of the American Academy of Sleep Medicine (2007) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27032 · Cited by 1,550
Research works printed but not linked: 2
- Wilcox, 1998, “Syndrome Z”: the interaction of sleep apnoea, vascular risk factors and heart disease, Thorax, 53, S25
- Pedrosa, 2011, Recent advances of the impact of obstructive sleep apnea on systemic hypertension, Arq Bras Cardiol, 97, e40
Cited by
Sorted by citations
Yeghiazarians, Y., Jneid, H., Tietjens, J. R., Redline, S., Brown, D. L., El-Sherif, N., Mehra, R., Bozkurt, B., Ndumele, C. E., Somers, V. K., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000988 · Cited by 1,431
Obstructive sleep apnoea syndrome
Lévy, P., Kohler, M., McNicholas, W. T., Barbé, F., McEvoy, R. D., Somers, V. K., Lavie, L., & Pépin, J.-L. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.15 · Cited by 1,235
Diretrizes Brasileiras de Hipertensão Arterial – 2020
Barroso, W. K. S., Rodrigues, C. I. S., Bortolotto, L. A., Gomes, M. A. M., Brandão, A. A., Feitosa, A. D. M., Machado, C. A., Poli‐de‐Figueiredo, C. E., Amodeo, C., Mion, D., et al. (2021) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20201238 · Cited by 1,389
Self-citationGalletly, C., Castle, D., Dark, F., Humberstone, V., Jablensky, A., Killackey, E., Kulkarni, J., McGorry, P., Nielssen, O., & Tran, N. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416641195 · Cited by 877
Nagappa, M., Liao, P., Wong, J., Auckley, D., Ramachandran, S. K., Memtsoudis, S., Mokhlesi, B., & Chung, F. (2015) · PLOS ONE · doi:10.1371/journal.pone.0143697 · Cited by 684
Metadata
- Authors
- Drager, L. F., Togeiro, S. M., Polotsky, V. Y., & Lorenzi-Filho, G.
- Affiliations
- Universidade de São Paulo (BR)
- Universidade Federal de São Paulo (BR)
- Johns Hopkins University (US)
- Corresponding author
- Drager, Luciano F.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 62
- Issue
- 7
- Pages
- 569-576
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC4461232
- OpenAlex
- W82112906
- Semantic Scholar
- d934a572c944ea22e897140990fef8af7b39baa3
- Cited by
- 886
- References
- 87
- Citations by year
- 2026: 103 · 2025: 106 · 2024: 77 · 2023: 56 · 2022: 71 · 2021: 80 · 2020: 82 · 2019: 50 · 2018: 49 · 2017: 37 · 2016: 58 · 2015: 63 · 2014: 47 · 2013: 7
- FWCI
- 40.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Funders
- National Heart, Lung, and Blood Institute (R01HL080105)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pharmacology (medical) › Apelin-related biomedical research
- Keywords
- obstructive sleep apnea, obesity, metabolic syndrome, intermittent hypoxia, insulin resistance, non-alcoholic fatty liver disease, cardiovascular risk, continuous positive airway pressure, arterial stiffness, atherosclerosis, cardiovascular mortality, endothelial dysfunction, systemic inflammation, sympathetic activation
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Female, Humans, Hypertension, Insulin Resistance, Male, Middle Aged, Obesity, Prognosis, Comorbidity, Body Mass Index, Incidence, Randomized Controlled Trials as Topic, Treatment Outcome, Risk Assessment, Cross-Over Studies, Sleep Apnea, Obstructive, Metabolic Syndrome, Continuous Positive Airway Pressure
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