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Sleep apnea in middle age raises heart disease risk
Published in Saudi Press Agency on 29 - 08 - 2006


Obstructive sleep apnea in
middle-aged adults may increase the risk of coronary artery
disease by up to five-fold, research in Sweden suggests.
However, successful treatment of the sleep apnea significantly
cuts that risk, Reuters reported.
Although evidence supports ties between sleep apnea -- that
is, brief but frequent episodes during the night when breathing
becomes blocked -- and coronary artery disease, a causal
relationship has not been established, Dr. Yuksel Peker and his
colleagues at Sahlgrenska University Hospital in Goteborg note.
The concomitant presence of other illnesses further complicates
the ability to delineate cause and effect.
For their study, Peker's team identified 308 middle-age
individuals (ages 30 to 69 years) who had been evaluated for
obstructive sleep apnea in 1991 and were free of any heart
disease at baseline. Nearly one-third (n=105) patients had
documented obstructive sleep apnea.
Patients were offered various standard treatments including
CPAP (continuous positive airway pressure), surgery, or an oral
appliance. Sleep apnea was not resolved despite treatment or
offers of treatment in 65 patients.
Over the next 7 years, coronary artery disease was
diagnosed in 16.2 percent of patients with sleep apnea and 5.4
percent of those without apnea. Eight deaths due to coronary
artery disease occurred in the apnea group and one in the
non-apnea group.
Among patients with ineffective treatment, coronary artery
disease was diagnosed in 24.6 percent versus 3.9 percent of
those effectively treated.
In "multivariate analysis," obstructive sleep apnea at
baseline nearly quintupled the risk of developing coronary
artery disease, the investigators report, regardless of age,
gender, high blood pressure, diabetes, or current smoking.
However, effective sleep apnea treatment reduced the
increased risk by about two thirds.
In the European Respiratory Journal, Peker's team maintains
that their study "clearly suggests a causal relationship
between obstructive sleep apnea and coronary artery disease."
"Even mild obstructive sleep apnea seems to have a
substantial effect on coronary artery disease risk, and highly
effective treatment should therefore be provided," they write.


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