Prevalence of Cardiovascular Disorders in Iranian Patients Suffering from Obstructive Sleep Apnea
-
Gholamreza Shirani
,
Seyyedeh Pouya Morovati
,
Ahmad Reza Shamshiri
,
Mehdi Nouri
,
Narges Ezzati Givi
,
Mohammad Farhadi
Abstract
Objectives: Obstructive sleep apnea (OSA) can lead to various cardiovascular disorders (CVD) such as hypertension. There is no documented data about this relationship among the Iranian population. The aim of this study was to obtain comprehensive information about the severity of OSA as a cause of CVD and its relationship with other important risk factors.
Materials and Methods: In this cross sectional study, we studied patients with OSA and apnea/hypopnea index of 5 or more. The data were collected from the patients’ polysomnography report and medical files. Data analysis was done with SPSS version 18.
Results: The majority of patients were males (71.9%). Among the studied individuals, 26.5% showed at least one sign of CVD, and hypertension was the most common condition (74.5%). Multiple regression analysis showed that the odds ratios for one unit increase in BMI and one year increase in age were 1.13 and 1.12, respectively (P<0.001).
Conclusions: In our study, BMI and age had the strongest relationship with CVD. Thus, public health care providers should implement weight control strategies and improve diagnostic and treatment procedures for the elderly patients.
- Padma A, Ramakrishnan N, Narayanan V. Management of obstructive sleep apnea: A dental perspective. Indian J Dent Res. 2007 Oct-Dec;18(4):201-9.
- Amra B, Farajzadegan Z, Golshan M, Fietze I, Penzel T. Prevalence of sleep apnea-related symp- toms in a Persian population. Sleep Breath. 2011 Apr,15(3):425-9.
- Khayat R, Patt B, Hayes DJR. Obstructive sleep apnea: the new cardiovascular disease. Part I: Obs- tructive sleep apnea and the pathogenesis of vascular disease. Heart Fail Rev. 2009 Sep; 14(3):143-53.
- Qaseem A, Dallas P, Owens DK, Starkey M, Holty JE, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014 Aug 5;161(3):210-20.
- Kuniyoshi FH, Pusalavidyasagar S, Singh P, Somers VK. Cardiovascular consequences of obstructtive sleep apnoea. Indian J Med Res. 2010 Feb;131:196-205.
- Walia HK, Li H, Rueschman M, Bhatt DL, Patel SR, Quan SF, et al. Association of severe obstructive sleep apnea and elevated blood pressure despite antihypertensive medication use J Clin Sleep Med.
Aug 15;10(8):835-43.
- Gami AS, Olson EJ, Shen WK, Wright RS, Ballman KV, Hodge DO, et al. Obstructive sleep apnea and the risk of sudden cardiac death: a longitudinal study of 10,701 adults. J Am Coll Cardiol. 2013 Aug 13;62(7):610-6.
- Mohsenin V. Obstructive sleep apnea: a new preventive and therapeutic target for stroke: a new kid on the block. Am J Med. 2015 Aug;128(8):811-6.
- Pedrosa RP, Drager LF, Gonzaga CC, Sousa MG, Paula LKG, Amaro ACS, et al. Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension. Hypertension. 2011 Nov;58(5):811-7.
- Redline S, Yenokyan G, Gottlieb DJ, Shahar E, O`Connor GT, Resnick HE, et al. Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med. 2010 Jul 15;182(2):269-77.
- Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation.2010 Feb 23;121(7):e46-e215.
- Trakada G, Economou NT, Nena E, Trakada A, Zarogoulidis P, Steiropoulos P. A health-economic analysis of diagnosis and treatment of obstructive sleep apnea with continuous positive airway pressure in relation to cardiovascular disease. The Greek experience. Sleep Breath. 2015 May;19(2):467-72.
- Yilmaz F, Ozyildirim S, Talay F, Karaaslan K, Gunduz H. Obstructive sleep apnea as a risk factor for cardiovascular diseases. Cardiol J. 2007 Jul;14(6):534-7.
- Zhang XB, Yuan YT, Du YP, Jiang XT, Zeng HQ. Efficacy of positive airway pressure on brain natriuretic peptide in patients with heart failure and sleep-disorder breathing: a meta-analysis of random ized controlled trials. Lung. 2015 Apr;193(2):255-60.
- Ballanti F, Raineri S, Baldini A, Cozza P. Long term therapeutic efficacy of a soft monobloc mandibular advancement device in adults with obstructive sleep apnea. ScientificWorldJournal.
;2015:408469.
- Mostovych N, Holmes L, Ruszkay N, LaHurd A, Heinle R, Nardone H. Effectiveness of Powered Intracapsular Tonsillectomy in Children With Severe Obstructive Sleep Apnea. JAMA Otolaryngol Head Neck Surg. 2016 Feb;142(2):150-6.
- Stewart S, Huang J, Mohorikar A, Jones A, Holmes S, Mackay SG. AHI Outcomes Are Superior after Upper Airway Reconstructive Surgery in Adult CPAP Failure Patients. Otolaryngol Head Neck Surg.
Mar;154(3):553-7.
- Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ, et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep. 2008 Aug;31(8):1071-8.
- Punjabi NM, Caffo BS, Goodwin JL, Gottlieb DJ, Newman AB, O'Connor GT, et al. Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med. 2009 Aug;6(8):e1000132.
- Gottlieb DJ, Yenokyan G, Newman AB, O'Connor GT, Punjabi NM, Quan SF, et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure the sleep heart health study. Circulation. 2010 Jul;122(4):352-60.
- Kendzerska T, Gershon AS, Hawker G, Leung RS, Tomlinson G. Obstructive sleep apnea and risk of cardiovascular events and all-cause mortality: a decade-long historical cohort study. PLoS Med. 2014 Feb 4;11(2):e1001599.
- Lavie L, Lavie P. Smoking interacts with sleep apnea to increase cardiovascular risk. Sleep Med.2008 Mar;9(3):247-53.
- Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, et al. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med. 2001 Jan;163(1):19-25.
- Dacal Quintas R, Tumbeiro Novoa M, Alves Pérez MT, Santalla Martínez ML, Acuña Fernández A, Marcos Velázquez P. Obstructive sleep apnea in normal weight patients: characteristics and com- parison with overweight and obese patients. Arch Bronconeumol. 2013 Dec;49(12):513-7.
- Seetho IW, Parker RJ, Craig S, Duffy N, Hardy KJ, Wilding JP. Obstructive sleep apnea is associated with increased arterial stiffness in severe obesity. J Sleep Res. 2014 Dec;23(6):700-8.
- Carlson JT, Hedner JA, Ejnell H, Peterson LE. High prevalence of hypertension in sleep apnea patients independent of obesity Am J Respir Crit Care Med. 1994 Jul;150(1):72-7.
- Lenfant C. Do sleep disorders have an impact on blood pressure? Am J Ther. 2008 Jul-Aug;15(4):345-50.
- Pływaczewski R, Czystowska M, Skoczylas A,Bieleń P, Jonczak L, Górecka D, Śliwiński P. Relationship between age and cardiovascular complications in obstructive sleep apnoea. Pneumonol Alergol Pol. 2009;77(3):235-41.
- Kendzerska T, Mollayeva T, Gershon AS, Leung RS, Hawker G, Tomlinson G.Untreated obstructive sleep apnea and the risk for serious long-term adverse outcomes: a systematic review. Sleep Med Rev. 2014 Feb;18(1):49-59.
- Drummond M, Winck JC, Pereira S, Almeida J, Marques JA. Obstructive sleep apnoea and cardiovascular disease--a retrospective study. Rev Port Pneumol. 2003 Jul-Aug;9(4):327-35.
- Quintana-Gallego E, Carmona-Bernal C, Capote F, Sánchez-Armengol A, Botebol-Benhamou G, Polo-Padillo J, et al. Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. Respir Med. 2004 Oct;98 (10):984-9.
- Faulx MD, Larkin EK, Hoit BD, Aylor JE, Wright AT, Redline S. Sex influences endothelial function in sleep-disordered breathing. Sleep. 2004 Sep 15;27 (6):1113-20.
- Mohsenin V, Yaggi HK, Shah N, Dziura J. The effect of gender on the prevalence of hypertension in obstructive sleep apnea. Sleep Med. 2009 Aug;10(7):759-62.
- Gaines J, Vgontzas AN, Fernandez-Mendoza J, Kritikou I, Basta M, Bixler EO. Gender differences in the association of sleep apnea and inflammation. Brain Behav Immun. 2015 Jul;47:211-7.
- Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002 May 1;165(9):1217-39.
- Ohsawa M, Okayama A, Nakamura M, Onoda T, Kato K, Itai K, et al. CRP levels are elevated in smokers but unrelated to the number of cigarettes and are decreased by long-term smoking cessation in male smokers. Prev Med. 2005 Aug;41(2):651-6.
- Peker Y, Hedner J, Kraiczi H, Löth S. Respiratory disturbance index: an independent predictor of mortality in coronary artery disease. Am J Respir Crit Care Med. 2000 Jul;162(1):81-6.
| Files | ||
| Issue | Vol 13, No 3 (2016) | |
| Section | Original Article | |
| Keywords | ||
| Sleep Apnea Obstructive Body Mass Index Cardiovascular Diseases Hypertension Aging | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
