Document Detail

Cardiovascular Mortality in Obstructive Sleep Apnea in the Elderly. Role of Long-Term CPAP Treatment: A Prospective Observational Trial.
MedLine Citation:
PMID:  22983957     Owner:  NLM     Status:  Publisher    
RATIONALE: Obstructive sleep apnoea (OSA) is a risk factor for cardiovascular death in middle-age subjects, but it is not known whether it is also a risk factor in the elderly. OBJECTIVES: To investigate whether OSA is a risk factor for cardiovascular death and assess whether continuous positive airway pressure (CPAP) treatment is associated with a change in risk in the elderly. METHODS: Prospective, observational study of a consecutive cohort of elderly patients (≥65 years) studied for suspicion of OSA between 1998 and 2007. Patients with an apnoea-hypopnea index (AHI)<15 were the control group. OSA was defined as mild to moderate (AHI of 15 to 29) or severe (AHI≥30). Patients with OSA were classified as CPAP-treated (adherence≥4 hours per day) or untreated (adherence<4 hours per day or not prescribed). Participants were followed up until December 2009. The endpoint was cardiovascular death. A multivariate Cox survival analysis was used to determine the independent impact of OSA and CPAP treatment on cardiovascular mortality. MAIN RESULTS: 939 elderly were studied (median follow-up, 69 months). Compared with the control group, the fully adjusted hazard ratios for cardiovascular mortality were 2.25 (CI,1.41 to 3.61) for the untreated severe OSA group, 0.93 (CI, 0.46 to 1.89) for the CPAP-treated group; and 1.38 (CI, 0.73 to 2.64) for the untreated mild to moderate OSA group. CONCLUSIONS: Severe OSA not treated with CPAP is associated with cardiovascular death in the elderly, and adequate CPAP treatment may reduce this risk.
Miguel-Angel Martinez-Garcia; Francisco Campos-Rodriguez; Pablo Catalán-Serra; Juan-José Soler-Cataluña; Carmen Almeida-Gonzalez; Ines De la Cruz Morón; Joaquín Durán-Cantolla; Josep-Maria Montserrat
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-13
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  -     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Pneumology Service, La Fe University and Polytechnic Hospital, Valencia, Spain.
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