Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study

The effect of obstructive sleep apnoea-hypopnoea as a cardiovascular risk factor and the potential protective effect of its treatment with continuous positive airway pressure (CPAP) is unclear. We did an observational study to compare incidence of fatal and non-fatal cardiovascular events in simple...

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Bibliographic Details
Published in:The Lancet (British edition) 2005-03, Vol.365 (9464), p.1046-1053
Main Authors: Marin, Jose M, Carrizo, Santiago J, Vicente, Eugenio, Agusti, Alvar GN
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - etiology
Cardiovascular Diseases - mortality
Comparative studies
Continuous Positive Airway Pressure
General aspects
Health risks
Hormones
Humans
Male
Medical sciences
Men
Middle Aged
Multivariate analysis
Myocardial infarction
Observational studies
Pneumology
Respiratory system : syndromes and miscellaneous diseases
Risk Factors
Sleep
Sleep Apnea, Obstructive - complications
Sleep Apnea, Obstructive - therapy
Sleep disorders
Snoring - complications
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Summary:The effect of obstructive sleep apnoea-hypopnoea as a cardiovascular risk factor and the potential protective effect of its treatment with continuous positive airway pressure (CPAP) is unclear. We did an observational study to compare incidence of fatal and non-fatal cardiovascular events in simple snorers, patients with untreated obstructive sleep apnoea-hypopnoea, patients treated with CPAP, and healthy men recruited from the general population. We recruited men with obstructive sleep apnoea-hypopnoea or simple snorers from a sleep clinic, and a population-based sample of healthy men, matched for age and body-mass index with the patients with untreated severe obstructive sleep apnoea-hypopnoea. The presence and severity of the disorder was determined with full polysomnography, and the apnoea-hypopnoea index (AHI) was calculated as the average number of apnoeas and hypopnoeas per hour of sleep. Participants were followed-up at least once per year for a mean of 10·1 years (SD 1·6) and CPAP compliance was checked with the built-in meter. Endpoints were fatal cardiovascular events (death from myocardial infarction or stroke) and non-fatal cardiovascular events (non-fatal myocardial infarction, non-fatal stroke, coronary artery bypass surgery, and percutaneous transluminal coronary angiography). 264 healthy men, 377 simple snorers, 403 with untreated mild-moderate obstructive sleep apnoea-hypopnoea, 235 with untreated severe disease, and 372 with the disease and treated with CPAP were included in the analysis. Patients with untreated severe disease had a higher incidence of fatal cardiovascular events (1·06 per 100 person-years) and non-fatal cardiovascular events (2·13 per 100 person-years) than did untreated patients with mild-moderate disease (0·55, p=0·02 and 0·89, p
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(05)71141-7