Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete upper airway obstruction, occurring during sleep, leading to chronic intermittent hypoxia (IH), which harms the cardiovascular system. OSA is associated with both functional and structural vascular alterations that contribute to an increased prevalence of fatal and non-fatal cardiovascular events. OSA is a heterogeneous disease with respect to the severity of hypoxia, the presence of daytime symptoms, obesity, and cardiovascular comorbidities. Various clusters of OSA phenotypes have been described leading to more highly personalized treatment. The aim of this review is to describe the various therapeutic strategies including continuous positive airway pressure (CPAP), oral appliances, surgery, weight loss, and especially pharmacological interventions that have been evaluated to reduce vascular alterations in both OSA patients and preclinical animal models. Conventional therapies, predominantly CPAP, have a limited impact on vascular alterations in the presence of co-morbidities. A better knowledge of pharmacological therapies targeting IH-induced vascular alterations will facilitate the use of combined therapies and is crucial for designing clinical trials in well-defined OSA phenotypes.

阻塞性睡眠呼吸暂停（OSA）的特征是在睡眠过程中反复发作部分或完全的上呼吸道阻塞，导致慢性间歇性缺氧（IH），这会损害心血管系统。OSA与功能性和结构性血管改变均相关，这会导致致命性和非致命性心血管事件的患病率增加。就缺氧的严重程度，白天症状的存在，肥胖症和心血管合并症而言，OSA是一种异质性疾病。已经描述了各种OSA表型簇，从而导致了更高程度的个性化治疗。这篇综述的目的是描述各种治疗策略，包括持续气道正压通气（CPAP），口服矫治器，手术，减肥，尤其是经过评估可减少OSA患者和临床前动物模型中血管变化的药理干预措施。在存在合并症的情况下，传统疗法（主要为CPAP）对血管改变的影响有限。更好地了解针对IH诱导的血管改变的药理疗法，将有助于联合疗法的使用，这对于设计定义明确的OSA表型的临床试验至关重要。