Rev Esp Cardiol
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Heart failure (HF) and sleep-disordered breathing are conditions highly prevalent in the general population that often co-exist in the same patient. Epidemiological and pathophysiological studies indicate that there may be a causal link between sleep-disordered breathing and HF with either left ventricular systolic dysfunction or preserved ejection fraction. ⋯ Although there are no available data to indicate that treating sleep-disordered breathing in HF patients reduce cardiac mortality, several studies demonstrate a significant improvement in structural and functional cardiovascular parameters. This review focuses on the clinical and epidemiological bases, the pathophysiological mechanisms and the therapeutic implications between HF and sleep apnea-hypopnea syndromes.
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The incidence of myocardial infarction in Spain is low, and mortality has been decreasing over the last few decades. The objective of this study was to analyze trends in myocardial infarction mortality, incidence, attack rates, and 28-day case-fatality attack rates between 1990 and 1999 in the general population aged 35-74 years in Girona, Spain. ⋯ Myocardial infarction incidence and mortality rates were low in the general population aged 35-64 years. Rates improved in men aged 35-64 years during the period 1990-1999, but not in those aged 65-74 years, which indicates that a combination of primary and secondary prevention has increased the age at which a myocardial infarction or its recurrence is observed. Rates in woman were lower and did not change during the study period.