High cardiovascular risk profile in patients with sleep apnea
Tobias E Herrscher1, Britt Overland, Leiv Sandvik
1Department of Cardiology, Lovisenberg Diakonale Hospital, Norway.
Insights
Patients with sleep apnea have a higher cardiovascular risk, with many undiagnosed hypertension and diabetes cases. Early screening is crucial for detecting these risks in sleep apnea patients.
Area of Science:
- Cardiology
- Sleep Medicine
- Internal Medicine
Background:
- Sleep apnea is linked to hypertension and diabetes, increasing cardiovascular disease (CVD) risk.
- Identifying individual CVD risk profiles in sleep apnea patients is crucial for early detection and management.
Purpose of the Study:
- To determine the cardiovascular risk profile in patients with sleep apnea.
- To detect premature and undiagnosed cardiovascular disease in sleep apnea patients.
Main Methods:
- Cross-sectional study of 255 patients evaluated over 6 months.
- Included clinical history, blood tests (OGTT), microalbuminuria testing, ECG, and Framingham risk score assessment.
- Patients were referred for sleep apnea evaluation.
Main Results:
- 75% of patients had sleep apnea, exhibiting higher Framingham risk scores.
- Severe sleep apnea correlated with a 60% increased CVD risk.
- Undiagnosed hypertension (45%), pathological glucose disposal (48%), and ECG changes (20%) were prevalent in sleep apnea patients.
Conclusions:
- High cardiovascular risk, undiagnosed hypertension, and glucose metabolism issues are common in sleep apnea.
- Implementing screening protocols is vital for identifying CVD risk factors in sleep apnea patients.
Objectives/Hypothesis:
Sleep apnea is associated with hypertension and diabetes, putting these patients at high risk for developing cardiovascular disease. The goal of this study was to identify the individual cardiovascular risk profile and to detect premature and undiagnosed disease in patients with various degrees of sleep apnea.
Study Design:
Cross-sectional.
Methods:
Over a 6-month period, we consecutively characterized all patients referred to our sleep laboratory for an initial evaluation of sleep apnea. Clinical history; blood tests with oral glucose tolerance test, when appropriate; test for microalbuminuria; and an electrocardiogram (ECG) were performed. The Framingham general cardiovascular risk score was assessed in each patient.
Results:
A total of 255 patients were evaluated. Of those, 190 (75%) were diagnosed with sleep apnea. Patients with sleep apnea had a significantly higher Framingham risk score than patients without sleep apnea. Adjusted for age and gender, severe sleep apnea was associated with a 60% increased cardiovascular risk compared with not having sleep apnea. In sleep apnea patients without previously diagnosed hypertension, an additional 45% had significant elevated blood pressure. Among sleep apnea patients without known diabetes, we tested 48% with a pathological glucose disposal. Twenty percent of sleep apnea patients without known heart disease had significant ECG changes.
Conclusions:
High Framingham score, undiagnosed hypertension, and pathological glucose disposal were highly prevalent in patients with sleep apnea. Appropriate screening routines are important to detect cardiovascular risk factors in patients with sleep apnea.
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