Intermittent Hypoxia and Atherosclerosis

  • Demet TekinEmail author
  • Elisa Chong
  • Lei Xi


Atherosclerosis is a common pathologic condition that is affecting millions of people in their large and small arteries, including the aorta, coronary, and cerebral arteries. Atherosclerotic lesions are characterized by focal thickening of the vascular tunica intima, through the accumulation of fatty deposits, platelets, and leukocytes in the endothelial cell layer, which eventually form the fatty streaks and plaques inside vascular walls. The subsequent ulceration and rupture of plaques could trigger the formation of thrombi that may partially or completely obstruct blood circulation and cause devastating consequences impairing the function and survival of vital organs. Therefore, atherosclerosis represents a distinguished basis of cardiac, cerebral, and peripheral vascular diseases. This chapter is aimed at providing a comprehensive and non-biased overview on the updated evidence of both detrimental and beneficial effects of intermittent hypoxia in the pathological process of atherosclerosis. Collectively, there is a remarkably abundant body of evidence for an atherogenic role played by chronic and severe intermittent hypoxia. On the other hand, a number of studies originated predominantly by Russian/Ukrainian scientists also demonstrated paradoxical anti-atherosclerosis prophylactic and therapeutic effects, which could be elicited by some well-controlled training/conditioning regimens with often mild or moderate levels of intermittent hypoxia. Considering these most updated evidence and divergent points of view, we have further discussed the possible molecular signaling pathways for both detrimental and protective mechanisms of IH. Nevertheless, many seemingly controversial areas require further investigations, which will undoubtedly bring new insights into the fundamental issue of prevention and treatment of atherosclerosis-associated ­cardiovascular diseases.


Nitric Oxide Vascular Endothelial Growth Factor Nitric Oxide Synthases Obstructive Sleep Apnea Continuous Positive Airway Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Apolipoprotein E




Continuous positive airway pressure


Endothelial-leukocyte adhesion molecule


Endothelial nitric oxide synthase


Endothelial progenitor cells




Free fatty acid


Fibroblast growth factor


Flow-mediated dilation


High-density lipoprotein


Hypoxia inducible factor 1


Intercellular adhesion molecule


Insulin-like growth factor


Intermittent hypoxia


Intermittent hypoxia training


Interleukin 6


Intima–media thickness


Inducible nitric oxide synthase


Low-density lipoprotein


Leukotriene B4


Monocyte chemotactic protein 1


Nicotinamide adenine dinucleotide phosphate


Nuclear factor kappa B


Nitric oxide


Nitric oxide synthase


Obstructive sleep apnea


Plasminogen activator inhibitor 1


Platelet-derived growth factor


Polymorphonuclear leukocytes


Respiratory disturbance index


Reactive oxygen species


Stearoyl coenzyme A desaturase 1


Smooth muscle cells


Sterol regulatory element-binding protein


Tissue factor


Toll-like receptor


Tumor necrosis factor-alpha


Triglyceride-rich lipoprotein


Vascular cell adhesion molecule


Vascular endothelial growth factor


Very-low-density lipoprotein



We like to thank Prof. Tatiana V. Serebrovskaya for sharing her vast knowledge of the relevant studies published in Russian and Ukrainian languages, which enabled us to provide a more balanced presentation of the less known and insufficiently recognized evidence for the beneficial role of intermittent hypoxia in limiting the atherogenic factors.


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Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  1. 1.Department of Physiology, School of MedicineAnkara UniversityAnkaraTurkey
  2. 2.Division of Cardiology, School of MedicineVirginia Commonwealth UniversityRichmondUSA

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