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Protective Cardiovascular Effect of Sleep Apnea Severity in Obesity Hypoventilation Syndrome
- Source :
- Chest, r-FISABIO. Repositorio Institucional de Producción Científica, instname, r-FISABIO: Repositorio Institucional de Producción Científica, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
- Publication Year :
- 2016
- Publisher :
- AMER COLL CHEST PHYSICIANS, 2016.
-
Abstract
- Background Obesity hypoventilation syndrome (OHS) is associated with a high burden of cardiovascular morbidity (CVM) and mortality. The majority of patients with OHS have concomitant OSA, but there is a paucity of data on the association between CVM and OSA severity in patients with OHS. The objective of our study was to assess the association between CVM and OSA severity in a large cohort of patients with OHS. Methods In a cross-sectional analysis, we examined the association between OSA severity based on tertiles of oxygen desaturation index (ODI) and CVM in 302 patients with OHS. Logistic regression models were constructed to quantify the independent association between OSA severity and prevalent CVM after adjusting for various important confounders. Results The prevalence of CVM decreased significantly with increasing severity of OSA based on ODI as a continuous variable or ODI tertiles. This inverse relationship between OSA severity and prevalence of CVM was seen in the highest ODI tertile and it persisted despite adjustment for multiple confounders. Chronic heart failure had the strongest negative association with the highest ODI tertile. No significant CVM risk change was observed between the first and second ODI tertiles. Patients in the highest ODI tertile were younger, predominantly male, more obese, more hypersomnolent, had worse nocturnal and daytime gas exchange, lower prevalence of hypertension, better exercise tolerance, and fewer days hospitalized than patients in the lowest ODI tertile. Conclusions In patients with OHS, the highest OSA severity phenotype was associated with reduced risk of CVM. This finding should guide the design of future clinical trials assessing the impact of interventions aimed at decreasing cardiovascular morbidity and mortality in patients with OHS. Trial Registry Clinicaltrial.gov; No.: NCT01405976 ; URL: www.clinicaltrials.gov
- Subjects :
- Pulmonary and Respiratory Medicine
Male
cardiovascular risk
medicine.medical_specialty
Polysomnography
precision medicine
Critical Care and Intensive Care Medicine
Logistic regression
Severity of Illness Index
Hypoxemia
03 medical and health sciences
0302 clinical medicine
Internal medicine
Obesity Hypoventilation Syndrome
obesity hypoventilation syndrome
Prevalence
Humans
Medicine
Hypoxia
Aged
Obesity hypoventilation syndrome
business.industry
Confounding
Sleep apnea
Middle Aged
Protective Factors
medicine.disease
sleep apnea
respiratory tract diseases
nervous system diseases
Clinical trial
Obstructive sleep apnea
Cross-Sectional Studies
030228 respiratory system
Apnea–hypopnea index
Cardiovascular Diseases
Spain
Concomitant
Heart failure
Physical therapy
Female
Blood Gas Analysis
medicine.symptom
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 00123692
- Database :
- OpenAIRE
- Journal :
- Chest, r-FISABIO. Repositorio Institucional de Producción Científica, instname, r-FISABIO: Repositorio Institucional de Producción Científica, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
- Accession number :
- edsair.doi.dedup.....35263581ad294c41ff065a75e8e6993c