Circulation: Sleep apnea in men boosts risk of HF, heart disease

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Middle-aged and older men diagnosed with severe obstructive sleep apnea (OSA) run a greater risk of developing heart failure (HF) and coronary heart disease, according to results of the Sleep Heart Health Study published July 12 in Circulation.

Because OSA is common and affects 24 percent of the male population and 9 percent of women, Daniel J. Gottlieb, MD, and colleagues from the Boston University School of Medicine enrolled 4,422 patients—1,927 men and 2,495 women—aged 40 and older, to assess the effect OSA had on HF.

Gottlieb and colleagues defined OSA as patients who had 30 or more breathing interruptions caused by oxygen depletion lasting 10 seconds or longer an hour.

All patients had no known history of heart problems at commencement of the study. After a mean follow up of 8.7 years, researchers found that 24 percent of men and 11 percent of women had moderate or severe OSA. Additionally, researchers found that diagnosis of moderate or severe OSA put men aged 40 to 70 at heightened risk—a 68 percent greater risk—for coronary heart disease.

"It's really time for us to perform clinical trials to assess whether coronary heart disease risk can be reduced in patients with severe sleep apnea by treating the apnea,” Gottlieb said.

Men who had very severe OSA also had a 58 percent greater risk of developing HF than those who were deemed as being free of OSA.

Gottlieb said that no links between OSA and heightened cardiac risk were found in women; however, because the cases of OSA in women were so small, the area should be further studied.

Limitations during the study stemmed from the fact that study subjects enrolled were free from heart problems at the start of the study, which could have excluded multiple patients who had suffered heart problems that may have been directly associated with OSA.

"The take-away from our study is that obstructive sleep apnea is a serious condition that warrants medical treatment," said Gottlieb. "Many patients don't experience symptoms of obstructive sleep apnea, such as daytime sleepiness, or if they do, don't mention it during routine medical exams. It's important for anyone who suspects they have obstructive sleep apnea to discuss it with their primary care physician."

The study was funded by the National Heart, Lung and Blood Institute.