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Title: Even Mild Sleep Apnoea Increases Cardiovascular Risk
URL: http://www.pslgroup.com/dg/23153A.htm
Doctor's Guide
October 24, 2008

NEW YORK -- October 24, 2008 -- People with even minimally symptomatic obstructive sleep apnoea (OSA) may be at increased risk for cardiovascular disease because of impaired endothelial function and increased arterial stiffness, according to a study in the November issue of American Journal of Respiratory and Critical Care Medicine.

Their findings suggested that minimally symptomatic OSA is a cardiovascular risk factor to a degree not previously known.

"It was previously known that people with OSA severe enough to affect their daytime alertness and manifest in other ways are at increased risk of cardiovascular disease, but this finding suggests that many more people -- some of whom may be completely unaware that they even have OSA -- are at risk than previously thought," said lead author Malcolm Kohler, MD, Oxford Centre for Respiratory Medicine, Oxford, United Kingdom.

To determine the exact nature of some of these effects, Dr. Kohler and colleagues performed a controlled, cross-sectional study to assess differences in endothelial function, arterial stiffness, and blood pressure in 64 patients with minimally symptomatic OSA. Patients were matched with 15 control subjects without OSA.

"In our study, the augmentation index, was significantly higher in patients with minimally symptomatic OSA compared with matched controls," said Dr. Kohler. "We also found impaired endothelial function as indicated by decreased vascular reactivity of their arteries compared with control subjects without OSA."

The difference in arterial stiffness between OSA patients and control subjects, Dr. Kohler said was "comparable in size to the effect seen after 4 weeks' continuous positive airway pressure (CPAP) therapy in patients with moderate to severe symptomatic OSA."

This suggests that asymptomatic or minimally symptomatic patients with OSA may enjoy a cardiovascular benefit from CPAP therapy.


SOURCE: American Thoracic Society

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