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RESEARCH PRODUCT
Long-term positive airway pressure therapy is associated with reduced total cholesterol levels in patients with obstructive sleep apnea : data from the European Sleep Apnea Database (ESADA)
Patrick LevyTarja SaaresrantaRenata L. RihaG. RoismanMehmet Sezai TaşbakanUlla AnttalainenUlla AnttalainenHolger HeinSébastien BaillyH. HeinJ.a. KvammeF. BarbéDing ZouSilke RyanJohan VerbraeckenPavol JoppaPaschalis SteiropoulosJan HednerJan HednerM. PetitjeanL. OndrejP. SteiropoulosMartin PretlWalter T. McnicholasCanan GunduzPiotr BielickiThomas PenzelE. PetietLudger GroteG. VaroneckasP. SliwinskiJ. VerbraeckenO.k. BasogluA. VitolsR. StaatsT. GalicIzolde BouloukakiAthanasia PatakaM. DrummondDaniel RodensteinGabriel RoismanR. PlywaczewskiO. MarroneGianfranco ParatiPeretz LavieM. Van ZellerLena LavieCarolina LombardiZoran DogasJ.m. MontserratOreste MarroneSofia SchizaJ.f. MasaR. TkacovaGeorgia TrakadaMarisa BonsignoreLudger GroteLudger GroteOzen K. BasogluP. JoppaRainer SchulzJan HednerJohn A. KvammeJ.l. PépinG. TrakadaBrian D. KentIngo FietzeU. Anttalainensubject
cardiovascular riskAdultMalemedicine.medical_specialtySettore MED/10 - Malattie Dell'Apparato RespiratorioPositive airway pressure03 medical and health sciences0302 clinical medicineInternal medicinePositive airway pressuremedicineCardiovascular risk Cholesterol Hypoxia Sleep apneaHumanspositive airway pressureProspective StudiesRisk factorProspective cohort studyHypoxiaAgedSleep Apnea ObstructiveFramingham Risk ScoreContinuous Positive Airway Pressurebusiness.industryhypoxiaSleep apneaSleep apneacholesterolGeneral MedicineMiddle Agedmedicine.diseasesleep apneaCardiovascular riskObstructive sleep apneaCardiovascular risk ; Cholesterol ; Hypoxia ; Positive airway pressure ; Sleep apnea.Cholesterol030228 respiratory systemPatient ComplianceFemaleHuman medicinebusinessBody mass index030217 neurology & neurosurgeryDyslipidemiadescription
Background and aim: Obstructive sleep apnea (OSA) is an independent risk factor for dyslipidemia. The current study examined the effects of positive airway pressure (PAP) treatment on lipid status in the European Sleep Apnea Database (ESADA). Methods: The prospective cohort study enrolled 1564 OSA subjects (74% male, mean age 54 ± 11y, body mass index (BMI) 32.7 ± 6.6 kg/m2 and apnea-hypopnea index (AHI) 40.3 ± 24.4 n/h) undergoing PAP therapy for at least three months (mean 377.6 ± 419.5 days). Baseline and follow-up total cholesterol (TC) from nine centers were analyzed. Repeated measures and logistic regression tests (adjusted for age, sex, weight changes, lipid lowering medication, PAP compliance, and treatment duration) were used to compare changes in TC concentration. Incident risk for a coronary heart disease event (CHD) was used to compute a Framingham CHD risk score (estimated from age, BMI, blood pressure, and TC). Results: Adjusted means of TC decreased from 194.2 mg/dl to 189.3 mg/dl during follow-up (p = 0.019). A clinically significant (10%) reduction of TC at PAP follow-up was observed in 422 patients (27%). Duration of PAP therapy was identified as independent predictor for TC reduction, which implies an approximately 10% risk reduction for incident CHD events (from 26.7% to 24.1% in men and from 11.2% to 10.1% in women, p < 0.001 respectively). Conclusion: This observational study demonstrates a reduction of TC after long-term PAP treatment. The close association between TC concentration and cardiovascular (CV) mortality suggests that identification and treatment of OSA may have a beneficial effect on overall CV risk due to this mechanism. This possibility needs to be evaluated in prospective randomized studies. © 2020 Elsevier B.V.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-01-01 | Sleep medicine |