OSA Increases Cardiovascular Mortality in the Elderly

Untreated severe OSA is associated with an increased risk of cardiovascular mortality in the elderly, and adequate treatment with CPAP may significantly reduce this risk, according to a new study from researchers in Spain titled “Cardiovascular Mortality in Obstructive Sleep Apnea in the Elderly, Role of Long-Term CPAP Treament”.

“Although the link between OSA and cardiovascular mortality is well established in younger patients, evidence on this relationship in the elderly has been conflicting,” said lead author Miguel Ángel Martínez-García, MD, of La Fe University and Polytechnic Hospital in Valencia, Spain. “In our study of 939 elderly patients, severe OSA not treated with CPAP was associated with an increased risk of cardiovascular mortality especially from stroke and heart failure, and CPAP treatment reduced this excess of cardiovascular mortality to levels similar to those seen in patients without OSA.”

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(With an impact factor of 11.080, the AJRRCM aims to publish the most innovative science and the highest quality reviews, practice guidelines, and statements in the pulmonary, critical care, and sleep-related fields).

All subjects in this prospective, observational study were 65 years of age or older. Median follow-up was 69 months. Sleep studies were conducted with either full standard polysomnography or respiratory polygraphy following Spanish guidelines. OSA was defined as mild-to-moderate (apnea-hypopnea index [AHI] 15-29) or severe (AHI ≥30). Patients with AHI <15 acted as controls. CPAP use ≥4 hours daily was considered as good adherence to treatment.

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