Journal ArticleDOI
Obstructive sleep apnea as a risk factor for stroke and death.
H. Klar Yaggi,John Concato,Walter N. Kernan,Judith H. Lichtman,Lawrence M. Brass,Vahid Mohsenin +5 more
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The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, including hypertension.Abstract:
background Previous studies have suggested that the obstructive sleep apnea syndrome may be an important risk factor for stroke. It has not been determined, however, whether the syndrome is independently related to the risk of stroke or death from any cause after adjustment for other risk factors, including hypertension. methods In this observational cohort study, consecutive patients underwent polysomnography, and subsequent events (strokes and deaths) were verified. The diagnosis of the obstructive sleep apnea syndrome was based on an apnea–hypopnea index of 5 or higher (five or more events per hour); patients with an apnea–hypopnea index of less than 5 served as the comparison group. Proportional-hazards analysis was used to determine the independent effect of the obstructive sleep apnea syndrome on the composite outcome of stroke or death from any cause. results Among 1022 enrolled patients, 697 (68 percent) had the obstructive sleep apnea syndrome. At baseline, the mean apnea–hypopnea index in the patients with the syndrome was 35, as compared with a mean apnea–hypopnea index of 2 in the comparison group. In an unadjusted analysis, the obstructive sleep apnea syndrome was associated with stroke or death from any cause (hazard ratio, 2.24; 95 percent confidence interval, 1.30 to 3.86; P=0.004). After adjustment for age, sex, race, smoking status, alcohol-consumption status, body-mass index, and the presence or absence of diabetes mellitus, hyperlipidemia, atrial fibrillation, and hypertension, the obstructive sleep apnea syndrome retained a statistically significant association with stroke or death (hazard ratio, 1.97; 95 percent confidence interval, 1.12 to 3.48; P=0.01). In a trend analysis, increased severity of sleep apnea at baseline was associated with an increased risk of the development of the composite end point (P=0.005). conclusions The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, including hypertension.read more
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Continuous positive airway pressure for adults with obstructive sleep apnea and cardiovascular disease: a meta-analysis of randomized trials
TL;DR: Low-quality evidence suggests that CPAP therapy does not significantly improve survival or prevent major cardiovascular events in adults with OSA and cardiovascular disease.
Journal ArticleDOI
The Relationship between Obstructive Sleep Apnea and Atrial Fibrillation: A Complex Interplay
TL;DR: The pathophysiology of OSA which may predispose to AF, clinical implications of stroke risk in this cohort who display overlapping disease processes, and targeted treatment strategies such as continuous positive airway pressure and AF ablation are explored.
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Recursos y demoras en el diagnóstico del síndrome de apneas-hipopneas durante el sueño (SAHS)
Juan Fernando Masa Jiménez,Ferran Barbé Illa,Francisco Capote Gil,Eusebio Chiner Vives,Josefa Díaz de Atauri,Joaquín Durán Cantolla,Salvador López Ortiz,José María Marín Trigo,José María Montserrat Canal,Manuela Rubio González,Joaquín Terán Santos,Carlos Zamarrón Sanz +11 more
TL;DR: Un analisis descriptivo de the situacion del diagnostico del SAHS en los hospitales espanoles sigue siendo mejorable y es imprescindible that las autoridades sanitarias dediquen mas recursos a este problema of salud publica.
Journal ArticleDOI
Structural and functional arterial properties in patients with obstructive sleep apnoea syndrome and cardiovascular comorbidities.
Athanassios D. Protogerou,Athanassios D. Protogerou,Laaban Jp,Sébastien Czernichow,Kostopoulos C,John Lekakis,Michel E. Safar,Jacques Blacher +7 more
TL;DR: Arterial stiffening and thickening are modulated by the severity of OSAS, independently from age and cardiovascular risk factors.
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Obstructive sleep apnea and hypertension: a critical review.
TL;DR: The literature supporting the significant role of OSA in hypertension and the effect of Osa treatment on blood pressure is discussed.
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