Social Vulnerability and Subclinical Cardiovascular Risk in Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is an established risk factor for cardiovascular disease (CVD). Multiple clinical factors, including OSA severity, obesity, smoking, and hypertension, mediate this risk. However, whether the association between OSA and CVD is influenced by non-clinical factors, specifically social determinants of health, remains unclear. We examined the association between neighborhood-level social determinants of health, indicated by the Social Vulnerability Index, and subclinical CVD risk in adults with untreated severe OSA. Racial and ethnic minority status (REMS) and socioeconomic status (SES) social vulnerability themes were associated with nocturnal hypertension and central arterial stiffness, independent of clinical factors. These findings highlight the need to investigate and integrate social determinants of health in OSA management and research to mitigate CVD risk.