0455 Association of high-risk obstructive sleep apnea with endothelial dysfunction in a large population-based sample in MiHeart Study

Abstract

Abstract Introduction Obstructive Sleep Apnea (OSA) is associated with endothelial dysfunction and cardiovascular disease (CVD). There are limited data evaluating the association with endothelial dysfunction measured by reactive hyperemia index (RHI) in an asymptomatic population free of CVD. We hypothesized that there would be a significant association between high risk of OSA and endothelial dysfunction in the Miami Heart (MiHeart) study, a population-based cohort of relatively young individuals free of known cardiovascular disease (CVD). Methods Cross-sectional data from 2097 participants (mean age: 53 years, 50% female) enrolled in the MiHeart study and underwent flow-mediated dilation using the EndoPat 2000 system was analyzed for this study. OSA was determined by Berlin questionnaire (high vs. low risk); logistic regression was utilized to examine the association between high OSA risk (reference low-risk OSA) and RHI (cut off < 1.67 vs. ≥1.67) in unadjusted models, and after accounting for age, sex, race/ethnicity (model 2), and BMI, diabetes, hypertension, high cholesterol, and smoking (model 3). Results 704 (34%) participants were categorized as high OSA risk, according to the Berlin questionnaire. These participants were more likely to be male, Hispanic and had a higher CVD risk factor burden when compared to low OSA risk. In addition, those with high OSA risk had higher prevalence of endothelial dysfunction (17.5% vs. 13.9%) than the low OSA risk (p < 0.05) group. High risk of OSA was associated with a higher risk of endothelial dysfunction in the unadjusted model (OR=1.32, 95% CI 1.03, 1.68). When adjusted for age, sex, and race/ethnicity, this association was slightly attenuated (OR 1.26, 95% CI 0.97, 1.62). Upon adjusting for CVD risk factors (model 3), the association between high-risk OSA and endothelial dysfunction was further attenuated and was not statistically significant (OR=1.18, 95% CI 0.87, 1.59). There was a strong, independent association between presence of diabetes and endothelial dysfunction (OR= 2.01, 95% CI 1.35, 2.94). Conclusion Younger individuals with high risk for OSA have elevated odds of endothelial dysfunction, and this relationship is likely mediated by demographics and cardiometabolic risk factors such as diabetes. Support (if any) The Miami Heart Study is funded by Baptist Health South Florida.