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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
Abstract
Background 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. Methods 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). Findings 264 healthy men, 377 simple snorers, 403 with untreated mild-moderate obstructive sleep apnoea-hypopnoea, 235 with untreated severe disease, and 372 with the…
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“However, there is a movement toward using more objective outcomes (e.g., ODI) and/or a 50% AHI decrease to under 15 events/h into the mild OSA range, which correlates with long-term health risk and mortality.114,118,433,434,638,642,660,683”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [118]
In the citing paper
“OSA has been linked to an increased risk of job-related and motor vehicle accidents, more frequent health-related missed workdays, and decreased quality of life.8”
From Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2021) · cites this paper as [8]
In the citing paper
“meta-analyses demonstrated clinically significant reductions in the risk ratio for mortality of 0.2 (95% CI: 0.1 to 0.5) and 0.4 (95% CI: 0.2 to 0.7) for heart failure 142,146 and no heart failure participants, 137,139,143,144,147 respectively”
In the citing paper
“It has also been substantiated in these studies that OSA increases the rate of new future occurrences of hypertension215).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [215]
In the citing paper
“severe OSA was linked to an increased risk of fatal cardiovascular events (odds ratio of 2.87; 1.17 – 7.51) as well as non-fatal cardiovascular events (odds ratio of 3.17, 1.12 −7.51) compared to a control of healthy individuals(84).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [84]
In the citing paper
“OSAS is associated with obesity, short and disrupted sleep, excessive daytime sleepiness, and high rates of morbidity and mortality, predominantly due to cardiovascular disease (28).”
From Quantity and Quality of Sleep and Incidence of Type 2 Diabetes (2010) · cites this paper as [28]
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Positionspapier „Schlafmedizin in der Kardiologie“
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Metadata
- Authors
- Marin, J. M., Carrizo, S. J., Vicente, E., & Agusti, A. G.
- Affiliations
- Hospital Universitario Miguel Servet (ES)
- ORCID
- Vicente, Eugenio
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2005-03
- Volume
- 365
- Issue
- 9464
- Pages
- 1046-1053
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2034556696
- Cited by
- 4,678
- References
- 54
- Citations by year
- 2026: 119 · 2025: 122 · 2024: 152 · 2023: 163 · 2022: 192 · 2021: 205 · 2020: 246 · 2019: 217 · 2018: 264 · 2017: 260 · 2016: 286 · 2015: 331 · 2014: 317 · 2013: 301 · 2012: 235
- FWCI
- 110.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pharmacology (medical) › Apelin-related biomedical research
- Keywords
- continuous positive airway pressure, cardiovascular outcomes, cardiovascular risk, simple snoring, CPAP therapy, apnea-hypopnea index, myocardial infarction, stroke, coronary artery bypass grafting, CPAP adherence, men, long-term follow-up, cardiovascular mortality
- MeSH terms
- Cardiovascular Diseases, Humans, Male, Middle Aged, Risk Factors, Snoring, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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