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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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| Published in: | The Lancet (British edition) 2005-03, Vol.365 (9464), p.1046-1053 |
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| container_title | The Lancet (British edition) |
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| creator | Marin, Jose M Carrizo, Santiago J Vicente, Eugenio Agusti, Alvar GN |
| description | 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 |
| doi_str_mv | 10.1016/S0140-6736(05)71141-7 |
| format | article |
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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<0·0001), simple snorers (0·34, p=0·0006 and 0·58, p<0·0001), patients treated with CPAP (0·35, p=0·0008 and 0·64, p<0·0001), and healthy participants (0·3, p=0·0012 and 0·45, p<0·0001). Multivariate analysis, adjusted for potential confounders, showed that untreated severe obstructive sleep apnoea-hypopnoea significantly increased the risk of fatal (odds ratio 2·87, 95%CI 1·17–7·51) and non-fatal (3·17, 1·12–7·51) cardiovascular events compared with healthy participants.
In men, severe obstructive sleep apnoea-hypopnoea significantly increases the risk of fatal and non-fatal cardiovascular events. CPAP treatment reduces this risk.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(05)71141-7</identifier><identifier>PMID: 15781100</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>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</subject><ispartof>The Lancet (British edition), 2005-03, Vol.365 (9464), p.1046-1053</ispartof><rights>2005 Elsevier Ltd</rights><rights>2005 INIST-CNRS</rights><rights>Copyright Lancet Ltd. Mar 19-Mar 25, 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-ea62d6c6c7cbf328975657a81f5c9f45ab8ed0bb3c46c7e289f6eb16451401093</citedby><cites>FETCH-LOGICAL-c402t-ea62d6c6c7cbf328975657a81f5c9f45ab8ed0bb3c46c7e289f6eb16451401093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,783,787,27936,27937</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16631067$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15781100$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marin, Jose M</creatorcontrib><creatorcontrib>Carrizo, Santiago J</creatorcontrib><creatorcontrib>Vicente, Eugenio</creatorcontrib><creatorcontrib>Agusti, Alvar GN</creatorcontrib><title>Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>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<0·0001), simple snorers (0·34, p=0·0006 and 0·58, p<0·0001), patients treated with CPAP (0·35, p=0·0008 and 0·64, p<0·0001), and healthy participants (0·3, p=0·0012 and 0·45, p<0·0001). Multivariate analysis, adjusted for potential confounders, showed that untreated severe obstructive sleep apnoea-hypopnoea significantly increased the risk of fatal (odds ratio 2·87, 95%CI 1·17–7·51) and non-fatal (3·17, 1·12–7·51) cardiovascular events compared with healthy participants.
In men, severe obstructive sleep apnoea-hypopnoea significantly increases the risk of fatal and non-fatal cardiovascular events. CPAP treatment reduces this risk.</description><subject>Biological and medical sciences</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Comparative studies</subject><subject>Continuous Positive Airway Pressure</subject><subject>General aspects</subject><subject>Health risks</subject><subject>Hormones</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Men</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Myocardial infarction</subject><subject>Observational studies</subject><subject>Pneumology</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Risk Factors</subject><subject>Sleep</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - 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Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marin, Jose M</au><au>Carrizo, Santiago J</au><au>Vicente, Eugenio</au><au>Agusti, Alvar GN</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>2005-03-19</date><risdate>2005</risdate><volume>365</volume><issue>9464</issue><spage>1046</spage><epage>1053</epage><pages>1046-1053</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>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<0·0001), simple snorers (0·34, p=0·0006 and 0·58, p<0·0001), patients treated with CPAP (0·35, p=0·0008 and 0·64, p<0·0001), and healthy participants (0·3, p=0·0012 and 0·45, p<0·0001). Multivariate analysis, adjusted for potential confounders, showed that untreated severe obstructive sleep apnoea-hypopnoea significantly increased the risk of fatal (odds ratio 2·87, 95%CI 1·17–7·51) and non-fatal (3·17, 1·12–7·51) cardiovascular events compared with healthy participants.
In men, severe obstructive sleep apnoea-hypopnoea significantly increases the risk of fatal and non-fatal cardiovascular events. CPAP treatment reduces this risk.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>15781100</pmid><doi>10.1016/S0140-6736(05)71141-7</doi><tpages>8</tpages></addata></record> |
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| ispartof | The Lancet (British edition), 2005-03, Vol.365 (9464), p.1046-1053 |
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| language | eng |
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| source | EBSCOhost Business Source Ultimate; ScienceDirect Freedom Collection 2022-2024 |
| 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 |
| title | Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study |
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