Impact of OSA on Abdominal Aortic Aneurysm
                     IMPACT OF OSA ON ABDOMINAL 
AORTIC ANEURYSM
IMPACT OF OSA ON ABDOMINAL 
AORTIC ANEURYSM
Abdominal aortic aneurysm (AAA) is a potentially life-threatening condition 
that may be exacerbated by Obstructive Sleep Apnea (OSA) which has been 
verified as an independent causal factor in the pathogenesis of hypertension 
and vascular dysfunction. More specifically, several pathomechanisms have 
:been suggested to account for the potential adverse effect of OSA on AAA
;The intrathoracic pressure changes leading to shear stress on artery walls .1
Intermittent hypoxia leading to oxidative stress, sympathetic stimulation, .2
;and possibly atherosclerosis
Arousal-induced sympathetic activation inducing subsequent repetitive .3
.blood pressure surges and chronic hypertension
IMPACT OF OSA ON ABDOMINAL 
AORTIC ANEURYSM
The attempts to link obstructive sleep apnea (OSA) to AAA are based on 
early studies of patients with Marfan’s syndrome. In the early 90s it was 
first suspected that OSA may have deleterious effects on the aorta in 
Marfan’s syndrome patients. Later researchers demonstrated higher 
prevalence of OSA in those patients and described a correlation between 
OSA severity (as measured by the apnea-hypopnea index (AHI)) and aortic 
root diameter (r=0.5, p4%) and AHI. Approximately 40% of the patients 
were found to have an ODI greater than 10 per hour, 
representing a 5-fold greater incidence than in a comparable 
 .normal population
IMPACT OF OSA ON ABDOMINAL 
AORTIC ANEURYSM
Similarly, 29% of the patients had AHI greater than 15, almost 2 
times higher than the normal prevalence values. These results 
correspond to other studies demonstrating up to 60% OSA 
presence in AAA patients which is significantly higher than the 
estimated prevalence of 17% in the general population. 
Importantly, subjective reports did not reveal a correlative 
sleepiness, suggesting that daytime sleepiness is not suitable for 
.detecting OSA in AAA patients
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