Influence of Comorbidity and Obesity on the Occurrence of Vascular Events in Obstructive Apnoea Treated with CPAP

Abstract

Background: Obesity has increased cardiovascular morbidity and mortality. It is the leading risk factor for obstructive sleep apnoea (OSA). The relationship between obesity-OSA and vascular disease seems clear. There is no consensus on whether CPAP (continuous positive airway pressure) treatment prevents vascular events. Objective: The aim of this study was to determine the effect of comorbidity and obesity on the risk of vascular events in patients with OSA treated with CPAP. Method: This study was a prospective study of historical cohorts of adult patients with OSA and CPAP. The sample was 3017 patients. Descriptive, survival (Kaplan–Meier) and Cox regression analyses were performed, calculating crude and adjusted association relationships to explain the risk of vascular events. Results: A total of 1726 patients were obese, 782 were diabetics, and 1800 were hypertensive. The mean adherence was 6.2 (±1.8 h/day), and the mean follow-up time was 2603 days (±953.3). In the COX regression analysis, the event-related variables were baseline age (HR: 1.025: 1.012–1.037; p < 0.001), pre-treatment vascular event (HR; 2.530: 1.959–3.266; p < 0.001), hypertension (HR; 1.871: 1.187–2.672; p = 0.005) and abbreviated Charlson comorbidity index (HR; 1.289: 1.100–1.510; p = 0.002). Conclusions: The occurrence of vascular events in OSA patients on CPAP treatment is related to hypertension, having a vascular event before treatment, age at the start of CPAP use and abbreviated Charlson comorbidity index.