Systemic effects of obstructive sleep apnea (OSA) syndrome include all of the following EXCEPT one. Which one is the EXCEPTION?

Correct answer: A. Cor pulmonale

• A. CORRECT (EXCEPTION) — Cor pulmonale (right heart failure from pulmonary hypertension) is NOT a well-established common systemic effect of OSA. OSA primarily causes left ventricular dysfunction and systemic hypertension, not primarily pulmonary hypertension leading to cor pulmonale.
• B. INCORRECT — Cardiac arrhythmias (particularly atrial fibrillation, bradyarrhythmias) are strongly associated with OSA.
• C. INCORRECT — While aortic aneurysm is less commonly cited, the repetitive surges in blood pressure and sympathetic tone in OSA have been linked to aortic dilation.
• D. INCORRECT — Hypertension is one of the most strongly associated systemic consequences of OSA, caused by repetitive nocturnal hypoxia and sympathetic activation.