2014年 · 第53卷第08期

Sleep disorders of breathing are closely related to stroke. sleep apnea is mainly obstructive sleep apnea (OSA), which is mainly characterized by repeated complete or partial obstruction of the upper airway during nighttime sleep, resulting in apnea and hypopnea, resulting in repeated intermittent hypoxia, CO₂Retention, repeated increase of negative pressure in the thoracic cavity, repeated awakening, abnormal sleep structure and decreased efficiency, daytime drowsiness, decreased memory, and autonomic nervous system dysfunction, etc. It is currently recognized that OSA is a systemic disease. In 2008, the American Heart Association (AHA) /American College of Cardiology Foundation (ACCF) issued a scientific statement that OSA is a newly recognized and interventionable independent risk factor for cardiovascular and cerebrovascular diseases such as hypertension, coronary heart disease, heart failure, arrhythmia, and stroke. Recent studies have also shown that OSA is closely related to insulin resistance and type II diabetes. OSA has become a major public health issue^[1,2,3,4]。

atrial fibrillation (AF) is a common arrhythmia that can manifest as paroxysmal, persistent and permanent. The prevalence of AF increased with age and was higher in males than females. The prevalence rate of AF is 1% ~2% in the overall population of European and American countries, and it is as high as 5% ~15% in people over 80 years old^[1]。 Epidemiological data in China show that the total prevalence of AF in the general population is 0.65%, and that in the people over 80 years old is 7.5%. Based on this, it is estimated that there are at least more than 4 million AF patients in China^[2]。 AF is one of the most important independent risk factors for ischemic stroke, and its risk of causing stroke is 5 times higher than those without AF^[3]。 Moreover, the risk of stroke caused by paroxysmal AF is substantially similar to that of persistent or permanent AF^[4]。 The recurrence rate of ischemic stroke in patients with AF was also significantly higher than that in patients without AF^[5]。 Preventive antithrombotic therapy for AF-induced stroke is mainly anticoagulation, which is significantly different from antiplatelet therapy for non-cardiogenic stroke.

Hypertension is the most important risk factor for cardiovascular and cerebrovascular diseases. At present, the blood pressure compliance rate of hypertensive patients in China is low. The survey of China Status showed that the blood pressure compliance rates of patients with hypertension combined with coronary heart disease, stroke, renal impairment and diabetes were 31.3%, 26.9%, 13.2% and 14.9%, respectively^[1]。 Therefore, multidisciplinary cooperation is urgently needed to improve the blood pressure compliance rate and reduce the risk of cardiovascular events and death in hypertensive patients.