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)

Maria Rosaria Bonsignore, Pataka, Paschalis Steiropoulos, Ulla Anttalainen, Ulla Anttalainen, Mehmet S. Tasbakan, Gabriel Roisman, Ondrej, Bouloukaki, Jan Hedner, Jean-Louis Pépin, Marisa R. Bonsignore, Mcnicholas, Sliwinski, Sofia Schiza, Brian D. Kent, Ding Zou, John Arthur Kvamme, Kvamme, Van ZellerBailly, Steiropoulos, Bielicki, Tkacova, Galic, Canan Gunduz, Johan Verbraecken, Schulz, Petiet, Vitols, Josep M. Montserrat, Penzel, Varoneckas, Gianfranco Parati, Oreste Marrone, Michel Petitjean, Hein, Ludger Grote, Gabriel Roisman, Georgia Trakada, Riha, Staats, Pretl, Trakada, Dogas, Plywaczewski, Saaresranta, Johan Verbraecken, Lavie, Masa, Marrone, Fietze, Jan Hedner, Rodenstein, Grote, Barbé, Carolina Lombardi, Holger Hein, Lavie, Drummond, Levy, Ozen K. Basoglu, Basoglu, Pavol Joppa, Joppa, Silke Ryan

Risultato della ricerca: Articlepeer review

Abstract

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.
Lingua originaleEnglish
pagine (da-a)201-209
Numero di pagine9
RivistaSleep Medicine
Volume75
Stato di pubblicazionePublished - 2020

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cita questo