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Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome.
Chest 2005; 127(6):2076-84Chest

Abstract

BACKGROUND

Obstructive sleep apnea syndrome (OSAS) has been associated with increased morbidity and mortality, principally from cardiovascular disease, but the impact of nasal continuous positive airway pressure (CPAP) therapy is unclear.

METHODS

We performed a long-term follow-up study of 168 patients with OSAS who had begun receiving CPAP therapy at least 5 years previously, most of whom had been prospectively followed up, having been the subject of an earlier report on cardiovascular risk factors in OSAS patients. The average follow-up period was 7.5 years. We compared the cardiovascular outcomes of those patients who were intolerant of CPAP (untreated group, 61 patients) with those continuing CPAP therapy (107 patients).

RESULTS

CPAP-treated patients had a higher median apnea-hypopnea index score than the untreated group (48.3 [interquartile range (IQR), 33.6 to 66.4] vs 36.7 [IQR, 27.4 to 55], respectively; p = 0.02), but age, body mass index, and time since diagnosis were similar. Deaths from cardiovascular disease were more common in the untreated group than in the CPAP-treated group during follow-up (14.8% vs 1.9%, respectively; p = 0.009 [log rank test]), but no significant differences were found in the development of new cases of hypertension, cardiac disorder, or stroke. Total cardiovascular events (ie, death and new cardiovascular disease combined) were more common in the untreated group than in the CPAP-treated group (31% vs 18%, respectively; p < 0.05).

CONCLUSIONS

The data support a protective effect of CPAP therapy against death from cardiovascular disease in patients with OSAS.

Authors+Show Affiliations

Respiratory Sleep Disorders Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15947323

Citation

Doherty, Liam S., et al. "Long-term Effects of Nasal Continuous Positive Airway Pressure Therapy On Cardiovascular Outcomes in Sleep Apnea Syndrome." Chest, vol. 127, no. 6, 2005, pp. 2076-84.
Doherty LS, Kiely JL, Swan V, et al. Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest. 2005;127(6):2076-84.
Doherty, L. S., Kiely, J. L., Swan, V., & McNicholas, W. T. (2005). Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest, 127(6), pp. 2076-84.
Doherty LS, et al. Long-term Effects of Nasal Continuous Positive Airway Pressure Therapy On Cardiovascular Outcomes in Sleep Apnea Syndrome. Chest. 2005;127(6):2076-84. PubMed PMID: 15947323.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. AU - Doherty,Liam S, AU - Kiely,John L, AU - Swan,Valerie, AU - McNicholas,Walter T, PY - 2005/6/11/pubmed PY - 2005/7/20/medline PY - 2005/6/11/entrez SP - 2076 EP - 84 JF - Chest JO - Chest VL - 127 IS - 6 N2 - BACKGROUND: Obstructive sleep apnea syndrome (OSAS) has been associated with increased morbidity and mortality, principally from cardiovascular disease, but the impact of nasal continuous positive airway pressure (CPAP) therapy is unclear. METHODS: We performed a long-term follow-up study of 168 patients with OSAS who had begun receiving CPAP therapy at least 5 years previously, most of whom had been prospectively followed up, having been the subject of an earlier report on cardiovascular risk factors in OSAS patients. The average follow-up period was 7.5 years. We compared the cardiovascular outcomes of those patients who were intolerant of CPAP (untreated group, 61 patients) with those continuing CPAP therapy (107 patients). RESULTS: CPAP-treated patients had a higher median apnea-hypopnea index score than the untreated group (48.3 [interquartile range (IQR), 33.6 to 66.4] vs 36.7 [IQR, 27.4 to 55], respectively; p = 0.02), but age, body mass index, and time since diagnosis were similar. Deaths from cardiovascular disease were more common in the untreated group than in the CPAP-treated group during follow-up (14.8% vs 1.9%, respectively; p = 0.009 [log rank test]), but no significant differences were found in the development of new cases of hypertension, cardiac disorder, or stroke. Total cardiovascular events (ie, death and new cardiovascular disease combined) were more common in the untreated group than in the CPAP-treated group (31% vs 18%, respectively; p < 0.05). CONCLUSIONS: The data support a protective effect of CPAP therapy against death from cardiovascular disease in patients with OSAS. SN - 0012-3692 UR - https://www.unboundmedicine.com/medline/citation/15947323/Long_term_effects_of_nasal_continuous_positive_airway_pressure_therapy_on_cardiovascular_outcomes_in_sleep_apnea_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(15)49812-5 DB - PRIME DP - Unbound Medicine ER -