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
Citations
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Journal ArticleDOI
Heart Disease and Stroke Statistics—2013 Update A Report From the American Heart Association
Alan S. Go,Dariush Mozaffarian,Véronique L. Roger,Emelia J. Benjamin,Jarett D. Berry,William B. Borden,Dawn M. Bravata,Shifan Dai,Earl S. Ford,Caroline S. Fox,Sheila Franco,Heather J. Fullerton,Cathleen Gillespie,Susan M. Hailpern,John A. Heit,Virginia J. Howard,Mark D. Huffman,Brett M. Kissela,Steven J. Kittner,Daniel T. Lackland,Judith H. Lichtman,Lynda D. Lisabeth,David J. Magid,Gregory M. Marcus,Ariane Marelli,David B. Matchar,Darren K. McGuire,Emile R. Mohler,Claudia S. Moy,Michael E. Mussolino,Graham Nichol,Nina P. Paynter,Pamela J. Schreiner,Paul D. Sorlie,Joel Stein,Tanya N. Turan,Salim S. Virani,Nathan D. Wong,Daniel Woo,Melanie B. Turner +39 more
TL;DR: Author(s): Go, Alan S; Mozaffarian, Dariush; Roger, Veronique L; Benjamin, Emelia J; Berry, Jarett D; Borden, William B; Bravata, Dawn M; Dai, Shifan; Ford, Earl S; Fox, Caroline S; Franco, Sheila; Fullerton, Heather J; Gillespie, Cathleen; Hailpern, Susan M; Heit, John A; Howard, Virginia J; Huff
Journal ArticleDOI
Heart Disease and Stroke Statistics—2012 Update A Report From the American Heart Association
Véronique L. Roger,Alan S. Go,Donald M. Lloyd-Jones,Emelia J. Benjamin,Jarett D. Berry,William B. Borden,Dawn M. Bravata,Shifan Dai,Earl S. Ford,Caroline S. Fox,Heather J. Fullerton,Cathleen Gillespie,Susan M. Hailpern,John A. Heit,Virginia J. Howard,Brett M. Kissela,Steven J. Kittner,Daniel T. Lackland,Judith H. Lichtman,Lynda D. Lisabeth,Diane M. Makuc,Gregory M. Marcus,Ariane Marelli,David B. Matchar,Claudia S. Moy,Dariush Mozaffarian,Michael E. Mussolino,Graham Nichol,Nina P. Paynter,Elsayed Z. Soliman,Paul D. Sorlie,Nona Sotoodehnia,Tanya N. Turan,Salim S. Virani,Nathan D. Wong,Daniel Woo,Melanie B. Turner +36 more
TL;DR: The American Heart Association's 2020 Impact Goals for Cardiovascular Diseases and Disorders are revealed, with a focus on preventing, treating, and preventing heart disease and stroke.
Journal ArticleDOI
Increased Prevalence of Sleep-Disordered Breathing in Adults
TL;DR: The prevalence of sleep-disordered breathing in the United States for the periods of 1988-1994 and 2007-2010 is estimated using data from the Wisconsin Sleep Cohort Study, an ongoing community-based study with participants randomly selected from an employed population of Wisconsin adults.
Journal ArticleDOI
Guidelines for the Primary Prevention of Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
Larry B. Goldstein,Cheryl Bushnell,Robert J. Adams,Lawrence J. Appel,Lynne T. Braun,Seemant Chaturvedi,Mark A. Creager,Antonio Culebras,Robert H. Eckel,Robert G. Hart,Judith A. Hinchey,Virginia J. Howard,Edward C. Jauch,Steven R. Levine,James F. Meschia,Wesley S. Moore,J.V. (Ian) Nixon,Thomas A. Pearson +17 more
TL;DR: Evidence-based recommendations are included for the control of risk factors, interventional approaches to atherosclerotic disease of the cervicocephalic circulation, and antithrombotic treatments for preventing thrombosis and thromboembolic stroke.
Journal ArticleDOI
The Epidemiology of Adult Obstructive Sleep Apnea
TL;DR: Some of the epidemiologic aspects of obstructive sleep apnea in adults are reviewed, namely, loud snoring, observed apneas, and daytime sleepiness, to help identify those in need of further diagnostic evaluation.
References
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Journal ArticleDOI
Sleep Apnea and Cardiovascular Disease
Journal ArticleDOI
Investigating the Relationship Between Stroke and Obstructive Sleep Apnea
TL;DR: Patients with stroke have an increased incidence of obstructive sleep apnea compared with normal sex- and age-matched control subjects, which may have predisposed these patients to stroke.
Journal ArticleDOI
Time Course of Sleep-related Breathing Disorders in First-Ever Stroke or Transient Ischemic Attack
Olga Parra,Adrià Arboix,S Bechich,Luis García-Eroles,Josep M. Montserrat,Josep Antoni López,Eugeni Ballester,Josep M. Guerra,Juan José Sopeña +8 more
TL;DR: The prevalence of SRBD in patients with first-ever stroke or TIA is higher than expected from the available epidemiological data in this country and obstructive events seem to be a condition prior to the neurological disease whereas central events and CSB could be its consequence.
Journal ArticleDOI
Sleep apnea in acute cerebrovascular diseases: final report on 128 patients.
TL;DR: Sleep apnea has a high frequency in patients with TIA and stroke, particularly in older patients with high BMI, diabetes, and severe stroke, which may have implications for prevention, acute treatment, and rehabilitation of patients with acute cerebrovascular diseases.
Journal ArticleDOI
Mortality in Sleep Apnea Patients: A Multivariate Analysis of Risk Factors
TL;DR: It is interpreted to suggest that SAS affects death indirectly, most probably by being a risk factor for hypertension.