Abstract
Objectives Obstructive sleep apnea syndrome (OSAS) is associated with increased cardiovascular morbidity and mortality. The aim of this study was to assess whether the 10-year risk for cardiovascular disease in newly diagnosed patients with OSAS is increased. Materials and Methods Recently diagnosed, with polysomnography, consecutive OSAS patients were included. The Systematic Coronary Risk Evaluation (SCORE) and the Framingham Risk Score (FRS) were used to estimate the 10-year risk for cardiovascular disease. Results Totally, 393 individuals (73.3% males), scheduled to undergo a polysomnographic study with symptoms indicative of OSAS, were enrolled. According to apnea-hypopnea index (AHI), subjects were divided in four groups: mild OSAS (AHI 5–14.9/h) was diagnosed in 91 patients (23.2%), moderate OSAS (AHI 15–29.9/h) in 58 patients (14.8%), severe OSAS (AHI > 30/h) in 167 patients (42.5%), while 77 individuals (19.6%) had an AHI < 5/h and served as controls. Increased severity of OSAS was associated with increased SCORE (p < 0.001) and FRS values (p < 0.001). More specifically, a significant correlation was observed both between AHI and SCORE (r=0.251, p < 0.001) and AHI and FRS values (r=0.291, p < 0.001). Furthermore, a negative correlation was observed between FRS values and sleep efficiency (r=−0.224, p=0.006). Conclusions The 10-year risk for cardiovascular morbidity and mortality seems to increase with severity of OSAS. Physicians should bear this finding in mind, in order to seek for and consecutively eliminate risk factors for cardiovascular disease and to prevent future cardiovascular events in OSAS patients.
Highlights
Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of partial or complete collapse of the upper airway during sleep, leading to oxyhaemoglobin desaturation, frequent arousals, and sleep fragmentation [1]
OSAS is associated with excessive daytime sleepiness, poor quality of life, reduced work productivity [3], increased overall morbidity, and mortality [4]
Mean age of the control group was significantly lower than that of any subgroup of OSAS patients (45.3 ± 10.1 for controls versus 48.8 ± 9.8 for mild OSAS, p 0.023; versus 53 ± 9.8 for moderate OSAS, p < 0.001; and versus 51 ± 9.7 years for severe OSAS, p < 0.001) while patients with severe OSAS had higher body mass index (BMI) compared with controls (35.5 ± 6.6 versus 32.5 ± 7.4 kg/m2, p 0.002)
Summary
Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of partial or complete collapse of the upper airway during sleep, leading to oxyhaemoglobin desaturation, frequent arousals, and sleep fragmentation [1]. It is a common disorder, with prevalence estimated at 10–17% for men and 3–9% for women, among adults in the developed countries [2]. OSAS and cardiovascular disease share common risk factors, such as obesity, hypertension, and diabetes [8]. Us, the association between OSAS and cardiovascular disease may be attributed to either a clustering of risk factors present in both conditions, or to a real causal role. OSAS and cardiovascular disease share common risk factors, such as obesity, hypertension, and diabetes [8]. us, the association between OSAS and cardiovascular disease may be attributed to either a clustering of risk factors present in both conditions, or to a real causal role. e aim of this study was to evaluate whether the estimated 10-year risk for cardiovascular morbidity and mortality, as assessed by Framingham Risk Score (FRS) and Systematic Coronary Risk Evaluation (SCORE), respectively, is increased in recently diagnosed patients with OSAS and to explore possible associations between those cardiovascular assessment risk scores with polysomnographic characteristics in OSAS
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