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Review
. 2019 Aug;156(2):402-413.
doi: 10.1016/j.chest.2019.02.011. Epub 2019 Feb 18.

OSA and Cardiovascular Risk in Pediatrics

David F Smith  1 , Raouf S Amin  2
Affiliations
Review

OSA and Cardiovascular Risk in Pediatrics

David F Smith et al. Chest. 2019 Aug.

Abstract

OSA occurs in approximately 1% to 5% of children in the United States. Long-term cardiovascular risks associated with OSA in the adult population are well documented. Although changes in BP regulation occur in children with OSA, the pathways leading to chronic cardiovascular risks of OSA in children are less clear. Risk factors associated with cardiovascular disease in adult populations could carry the same future risk for children. It is imperative to determine whether known mechanisms of cardiovascular diseases in adults are like those that lead to pediatric disease. Early pathophysiologic changes may lead to a lifetime burden of cardiovascular disease and early mortality. With this perspective in mind, our review discusses pathways leading to cardiovascular pathology in children with OSA and provides a comprehensive overview of recent research findings related to cardiovascular sequelae in the pediatric population.

Keywords: OSA; cardiovascular; pediatrics; risk factors.

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Figures

Figure 1
Figure 1
Relationship between inflammation and OSA. Systemic and tissue-specific inflammation mediates cardiovascular and metabolic disturbances that also contribute to the relationship between central adiposity and OSA. REM = rapid eye movement.
Figure 2
Figure 2
Cytokine levels (evening [blue lines] vs morning [red lines]) for healthy participants and children with mild vs severe OSA; data are reported as mean ± SD. Healthy participants and children with OSA aged 5 to 13 years were recruited to the study. All participants underwent overnight polysomnography with evening and morning blood draws for cytokine and acute-phase reactant level measurements. Cytokine levels were measured at 6:00 pm and 6:00 am. Serum IL-6, IL-8, and TNF-α exhibited a difference in diurnal variation in children with OSA compared with healthy control subjects. In control patients, cytokine levels decreased from evening to morning. In children with mild and severe OSA, cytokine levels increased from evening to morning. TNF-α = tumor necrosis factor α. The figure was created by using data presented previously by Smith et al.
See this image and copyright information in PMC

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