Mitigating Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Using GLP-1 Receptor Agonists and SGLT2 Inhibitors: Hype or Hope?

Obstructive sleep apnea (OSA) is a prevalent condition associated with increased cardiovascular risk, particularly in individuals with comorbid obesity and type 2 diabetes (T2D). Despite the widespread use of continuous positive airway pressure (CPAP) for OSA management, adherence remains suboptimal...

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Main Authors: Paschalis Karakasis, Marios Sagris, Dimitrios Patoulias, Theocharis Koufakis, Panagiotis Theofilis, Aleksandra Klisic, Nikolaos Fragakis, Mohamed El Tanani, Manfredi Rizzo
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/12/11/2503
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author Paschalis Karakasis
Marios Sagris
Dimitrios Patoulias
Theocharis Koufakis
Panagiotis Theofilis
Aleksandra Klisic
Nikolaos Fragakis
Mohamed El Tanani
Manfredi Rizzo
author_facet Paschalis Karakasis
Marios Sagris
Dimitrios Patoulias
Theocharis Koufakis
Panagiotis Theofilis
Aleksandra Klisic
Nikolaos Fragakis
Mohamed El Tanani
Manfredi Rizzo
author_sort Paschalis Karakasis
collection DOAJ
description Obstructive sleep apnea (OSA) is a prevalent condition associated with increased cardiovascular risk, particularly in individuals with comorbid obesity and type 2 diabetes (T2D). Despite the widespread use of continuous positive airway pressure (CPAP) for OSA management, adherence remains suboptimal, and CPAP has not consistently demonstrated reductions in surrogate cardiovascular events. Recently, attention has focused on glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors as potential therapeutic agents for mitigating cardiovascular risk in OSA patients. These agents, originally developed for T2D management, have demonstrated pleiotropic effects, including significant weight loss, blood pressure reduction, and amelioration of endothelial dysfunction and arterial stiffness, along with anti-inflammatory benefits, which may be particularly beneficial in OSA. Emerging clinical evidence suggests that GLP-1RAs and SGLT2 inhibitors can reduce OSA severity and improve daytime sleepiness, potentially reversing the adverse cardiovascular effects observed in OSA. This review explores the pathophysiological mechanisms linking OSA with cardiovascular disease and evaluates the potential therapeutic roles of GLP-1RAs and SGLT2 inhibitors in addressing cardiovascular risk in OSA patients. Further research, including long-term clinical trials, is necessary to establish the effectiveness of these therapies in reducing cardiovascular events and improving patients’ reported outcomes in this population.
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spelling doaj-art-35f9180ece7240e7badbc48caf4ebc642025-08-20T02:08:08ZengMDPI AGBiomedicines2227-90592024-11-011211250310.3390/biomedicines12112503Mitigating Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Using GLP-1 Receptor Agonists and SGLT2 Inhibitors: Hype or Hope?Paschalis Karakasis0Marios Sagris1Dimitrios Patoulias2Theocharis Koufakis3Panagiotis Theofilis4Aleksandra Klisic5Nikolaos Fragakis6Mohamed El Tanani7Manfredi Rizzo8Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreeceFirst Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, GreeceSecond Propedeutic Department of Internal Medicine, Faculty of Medicine, School of Health Sciences Aristotle, University of Thessaloniki, 54642 Thessaloniki, GreeceSecond Propedeutic Department of Internal Medicine, Faculty of Medicine, School of Health Sciences Aristotle, University of Thessaloniki, 54642 Thessaloniki, GreeceFirst Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, GreecePrimary Health Care Center, Faculty of Medicine, University of Montenegro, 81000 Podgorica, MontenegroSecond Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreeceRas Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab EmiratesRas Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab EmiratesObstructive sleep apnea (OSA) is a prevalent condition associated with increased cardiovascular risk, particularly in individuals with comorbid obesity and type 2 diabetes (T2D). Despite the widespread use of continuous positive airway pressure (CPAP) for OSA management, adherence remains suboptimal, and CPAP has not consistently demonstrated reductions in surrogate cardiovascular events. Recently, attention has focused on glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors as potential therapeutic agents for mitigating cardiovascular risk in OSA patients. These agents, originally developed for T2D management, have demonstrated pleiotropic effects, including significant weight loss, blood pressure reduction, and amelioration of endothelial dysfunction and arterial stiffness, along with anti-inflammatory benefits, which may be particularly beneficial in OSA. Emerging clinical evidence suggests that GLP-1RAs and SGLT2 inhibitors can reduce OSA severity and improve daytime sleepiness, potentially reversing the adverse cardiovascular effects observed in OSA. This review explores the pathophysiological mechanisms linking OSA with cardiovascular disease and evaluates the potential therapeutic roles of GLP-1RAs and SGLT2 inhibitors in addressing cardiovascular risk in OSA patients. Further research, including long-term clinical trials, is necessary to establish the effectiveness of these therapies in reducing cardiovascular events and improving patients’ reported outcomes in this population.https://www.mdpi.com/2227-9059/12/11/2503obstructive sleep apneaglucagon-like peptide-1 receptor agonistssodium-glucose cotransporter-2 inhibitorscardiovascular riskobesitytype 2 diabetes
spellingShingle Paschalis Karakasis
Marios Sagris
Dimitrios Patoulias
Theocharis Koufakis
Panagiotis Theofilis
Aleksandra Klisic
Nikolaos Fragakis
Mohamed El Tanani
Manfredi Rizzo
Mitigating Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Using GLP-1 Receptor Agonists and SGLT2 Inhibitors: Hype or Hope?
Biomedicines
obstructive sleep apnea
glucagon-like peptide-1 receptor agonists
sodium-glucose cotransporter-2 inhibitors
cardiovascular risk
obesity
type 2 diabetes
title Mitigating Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Using GLP-1 Receptor Agonists and SGLT2 Inhibitors: Hype or Hope?
title_full Mitigating Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Using GLP-1 Receptor Agonists and SGLT2 Inhibitors: Hype or Hope?
title_fullStr Mitigating Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Using GLP-1 Receptor Agonists and SGLT2 Inhibitors: Hype or Hope?
title_full_unstemmed Mitigating Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Using GLP-1 Receptor Agonists and SGLT2 Inhibitors: Hype or Hope?
title_short Mitigating Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Using GLP-1 Receptor Agonists and SGLT2 Inhibitors: Hype or Hope?
title_sort mitigating increased cardiovascular risk in patients with obstructive sleep apnea using glp 1 receptor agonists and sglt2 inhibitors hype or hope
topic obstructive sleep apnea
glucagon-like peptide-1 receptor agonists
sodium-glucose cotransporter-2 inhibitors
cardiovascular risk
obesity
type 2 diabetes
url https://www.mdpi.com/2227-9059/12/11/2503
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