Association Between Obstructive Sleep Apnea and Cardiovascular Risk: A Systematic Review and Meta-Analysis of...

Area of Science:

• Cardiology
• Sleep Medicine
• Public Health

Background:

• Obstructive sleep apnea (OSA) is a common condition linked to elevated cardiovascular disease (CVD) risk.
• Understanding the precise relationship between OSA severity and CVD incidence is crucial for patient management.

Purpose of the Study:

• To systematically review and meta-analyze prospective cohort studies evaluating the association between OSA and incident cardiovascular outcomes.
• To assess the impact of OSA severity and continuous positive airway pressure (CPAP) adherence on cardiovascular risk.

Main Methods:

• A PRISMA-compliant systematic review and meta-analysis of prospective cohort studies.
• Included 18 studies with over 25,000 participants and a median follow-up of 9 years.
• Dose-response and subgroup analyses were performed to evaluate OSA severity and CPAP adherence effects.

Main Results:

• OSA was significantly associated with an increased risk of incident cardiovascular outcomes (pooled HR 1.82).
• A dose-response relationship was observed, with severe OSA conferring the highest risk (HR 2.45).
• Adequate CPAP adherence (≥4 hours/night) was associated with a reduced cardiovascular risk (HR 0.76).

Conclusions:

• OSA presents a cardiovascular risk that is dependent on its severity.
• Effective management with continuous positive airway pressure (CPAP) and good adherence can significantly reduce cardiovascular morbidity and mortality.
• Systematic screening for OSA and support for CPAP adherence are recommended to lower cardiovascular disease burden.