Abstract
Rationale: Both obesity and obstructive sleep apnea (OSA) are risk factors for hypertension (HT) and chronic heart failure (CHF). The association between OSA and COPD (overlap syndrome) and the obesity hypoventilation syndrome (OHS) have been proposed as leading to enhanced cardiovascular risk.
Methods: 3093 obese subjects (IMC>30kg/m2) referred for suspicion of OSA were prospectively assessed by sleep studies, lung function tests and blood gazes. For the whole group, mean age was 57±13 years with 66% of men, mean BMI: 36.8±6.2 kg/m2, 52.8% of the subjects being hypertensive and 3.23% suffering from CHF. 926 of the 3093 did not exhibit OSA or COPD.
Results: In multivariate analysis, prevalent hypertension was associated with OSA (Odd ratio (OR): 1.23 (confidence intervals (CI): 1.04-1.45), p=0.015), ≥2 nocturia episodes per night (OR: 1.295 (CI: 1.10-1.52), p<0.01), type 2 diabetes (OR: 2.12 (CI: 1.56-2.88), p<0.01), hypercholesterolemia (OR: 1.94 (CI: 1.6-2.34), p<0.01), reduced physical activity (OR: 1.25 (CI: 1.04-1.49), p<0.01), each one unit increase in BMI increase (OR: 1.025 (CI: 1.01-1.04), p<0.01), each one unit increase in age (OR: 1.06 (CI: 1.04-1.07), p<0.01). In multivariate analysis, cardiac failure was explained by diurnal hypoventilation (OR: 2.64 (CI: 1.67-4.29), p<0.01), reduced physical activity (OR: 3.73 (CI: 2.44-5.7), p<0.01), former smoking (OR: 1.63 (CI: 1.06-2.51), p=0.025), and each one unit increase in age (OR: 1.07 (CI: 1.03-1.11), p<0.01).
Conclusions: Sleep apnea was linked with HT independently of other classical cardiovascular risk factors. Diurnal hypoventilation was highly predictive of cardiac failure.
- © 2011 ERS