Affiliation:
1. Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region
Abstract
Abstract
Objectives: Both obstructive sleep apnea (OSA) and hypertension are risk factors of cardiovascular diseases (CVDs). The study aimed to observe the effect of the coexistence of OSA and hypertension on CVDs and evaluate the impact of antihypertensive treatment on CVDs outcomes in this population.
Study Design: This is a retrospective cohortstudy.
Methods: Hypertensive patients who underwent polysomnography (PSG) test in Jan 2011 to Dec 2013 were enrolled. OSA was defined as apnea hypopnea index(AHI)≥ 5. Outcomes were extended major adverse cardiovascular and cerebrovascular events (MACCE), including the first occurrence of non-fatal myocardial infarction, non-fatal stroke, revascularization, cardiac rehospitalization due to unstable angina or heart failure and all-cause death. The effect of the coexistence of OSA and hypertension on MACCE was explored by Cox regression analysis.
Results: Overall, 415 individuals out of 3329 hypertensives experienced extended MACCE. At a median follow-up of 7.0 years, the incidence of extended MACCE was significantly higher in OSA group than in non-OSA group (hazard ratio [HR]: 1.59; 95% confidence interval [CI]:1.27-1.99; P<0.001). Totally, OSA patients had a 57% increased risk of cardiac events than subjects without OSA [HR(95%CI):1.57 (1.04-2.39), P=0.034] and the association did not change in further sensitivity analysis. Especially in uncontrolled hypertension, OSA showed a 93% increased risk of cardiac events compared to patients without OSA(P=0.036) .
Conclusion: OSA remains a risk factor of cardiac events, while the association between OSA and cardiac events would be attenuated by the pharmacological-induced blood pressure control.
Publisher
Research Square Platform LLC
Reference31 articles.
1. Benjafield Adam V., Ayas Najib T., Eastwood Peter R., Heinzer Raphael., Ip Mary S M., Morrell Mary J., Nunez Carlos M., Patel Sanjay R., Penzel Thomas., Pépin Jean-Louis., Peppard Paul E., Sinha Sanjeev., Tufik Sergio., Valentine Kate., Malhotra Atul. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 2019; 7: 687–698. https://doi.org/10.1016/S2213-2600(19)30198-5.
2. Sleep breathing disorders in heart failure;Coniglio AC;Heart Fail Clin,2020
3. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study;Marin JM;Lancet,2005
4. Untreated obstructive sleep apnea and the risk for serious long-term adverse outcomes: a systematic review;Kendzerska T;Sleep Med Rev,2014
5. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin Sleep Cohort;Young T;Sleep,2008