Heart Health
topic
Sleep's role in cardiovascular health operates through multiple mechanisms: nighttime blood pressure dipping (NREM sleep producing a 10–20% BP reduction that provides cardiovascular recovery and whose absence independently predicts cardiovascular events), sympathetic nervous system downregulation, reduced inflammatory cytokine production, endothelial repair, and the direct association between short sleep duration and atherosclerosis progression, myocardial infarction risk, and stroke risk in large prospective studies.
Role
Cardiovascular disease is the leading cause of death in developed nations, and sleep is an independent modifiable risk factor whose magnitude is comparable to established risk factors but whose management is almost absent from standard cardiovascular prevention protocols. The person with hypertension who is prescribed medication but not evaluated for sleep apnea — one of the most common secondary causes of treatment-resistant hypertension — has had the primary driver of their elevated blood pressure overlooked in favor of its pharmacological management. Sleep evaluation should be a routine component of cardiovascular risk assessment that it currently almost never is.