Impact of race and obesity on arterial endothelial dysfunction associated with sleep apnea: Results from the Heart SCORE study

Olafiranye, Oladipupo; Kip, Kevin E.; Rhinehart, Zachary; Mulukutla, Suresh; Aiyer, Aryan; Strollo, Patrick J.; Reis, Steven E.

doi:10.1016/j.ijcard.2015.08.098

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…Several studies have reported an association between the presence and/or severity of OSA and endothelial dysfunction that is independent of not only BMI, but also traditional cardiovascular risk factors including smoking, BP, lipids, and diabetes. 21,33,34 Nonetheless, other studies found the opposite. For example, in a recent study of 53 obese adults with OSA, the severity of OSA was not significantly associated with endothelial dysfunction, even after adjustment for age, sex, BMI, waist circumference, alcohol intake, and physical activity.…”

Section: Discussionmentioning

confidence: 90%

Correlates of Endothelial Function in Older Adults With Untreated Obstructive Sleep Apnea and Cardiovascular Disease

et al. 2019

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Background: Obstructive sleep apnea (OSA) is a highly prevalent and consequential sleep disorder in older adults. Untreated moderate to severe OSA substantially increases the risk for hypertension and cardiovascular disease (CVD), which can be attributed to the accelerated progression of atherosclerosis and endothelial dysfunction. Objective: The aim of this study was to identify factors that can function as correlates of endothelial function in older adults with untreated, moderate to severe OSA and CVD or CVD risk factors. Methods: A subsample (N = 126) of adults aged 65 years and older from the HeartBEAT study were included in the analyses. Univariate analyses and multiple linear regression models were conducted to establish which demographic and CVD risk factors were the best correlates of endothelial function. Results: In the univariate analyses, sex, employment status, body mass index, waist circumference, hip-to-waist ratio, neck circumference, diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, total cholesterol to high-density lipoprotein cholesterol ratio, plasminogen activator inhibitor-1, calcium channel blocker use, and beta-blocker use were associated with endothelial function at a level of P < .10. In the most parsimonious model, male sex (b = −0.305, P < .001), calcium channel blocker use (b = −0.148, P < .019), and body mass index (b = −.014, P < .037) were negatively associated with endothelial function after adjusting for the other covariates. Conclusions: The authors identified the correlates of endothelial function in older adults with untreated OSA and CVD or CVD risk factors, which are different than the correlates in middle-aged adults with the same conditions.

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Section: Discussionmentioning

confidence: 90%

Correlates of Endothelial Function in Older Adults With Untreated Obstructive Sleep Apnea and Cardiovascular Disease

et al. 2019

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“…The final result of this process is the development of endothelial dysfunction and micro-vascular impairment [28]. Several clinic-based and population-based studies have demonstrated that OSA is associated with severity-dependent deterioration of endothelial function assessed by RHI in both adults and children [29–34]. Microparticles (MPs) are small plasma membrane vesicles that can be released by a variety of vascular or blood cells and contain both membrane and cytosolic elements.…”

Section: Introductionmentioning

confidence: 99%

Association between obstructive sleep apnea severity and endothelial dysfunction in patients with type 2 diabetes

Bironneau

Goupil

Ducluzeau

et al. 2017

Cardiovasc Diabetol

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BackgroundObstructive sleep apnea (OSA) and type 2 diabetes (T2D) are associated with endothelial dysfunction a main predictor of late cardiovascular (CV) events. Despite the high prevalence of OSA in patients with T2D, the impact of OSA severity on endothelial function has not been clearly elucidated. The aim of this cross-sectional study was to determine whether increasing OSA severity is associated with poorer endothelial function in patients with T2D.Methods140 patients with T2D and no overt CV disease underwent polysomnography, peripheral arterial tonometry, clinic blood pressure (BP) measurement, biological assessment for CV risk factors, daytime sleepiness and health related quality of life (HRQL) questionnaires. The following commonly used cut-offs for apnea-hypopnea index (AHI) were used to define 3 categories of disease severity: AHI < 15 (no OSA or mild OSA), 15 ≤ AHI < 30 (moderate OSA), and AHI ≥ 30 (severe OSA). The primary outcome was the reactive hyperemia index (RHI), a validated assessment of endothelial function.Results21.4% of patients had moderate OSA and 47.6% had severe OSA. Increasing OSA severity and nocturnal hypoxemia were not associated with a significant decrease in RHI. Endothelial dysfunction (RHI < 1.67) was found in 47.1, 44.4 and 39.2% of patients with no OSA or mild OSA, moderate OSA and severe OSA, respectively (p = 0.76). After adjustment for confounders including body mass index, increasing OSA severity was associated with higher systolic BP (p = 0.03), lower circulating levels of adiponectin (p = 0.0009), higher levels of sP-selectin (p = 0.03), lower scores in 3 domains of HRQL including energy/vitality (p = 0.02), role functioning (p = 0.01), and social functioning (p = 0.04).ConclusionsModerate to severe OSA is very common but has no impact on digital micro-vascular endothelial function in patients with T2D.

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“…Class III obesity has increased, and now affects, almost 1 in 20 Americans . As BMI increases above the normal range, there is also a corresponding increase in health risks, including diabetes mellitus, hyperlipidaemia, sleep apnoea and atrial fibrillation (,) with a lower rate at lower BMIs and a higher rate with greater degrees of obesity. The Behavioral Risk Factor Surveillance System (BRFSS) found that compared with normal‐weight adults, extremely obese adults had much higher risk for having hypertension (HTN), diabetes, arthritis, asthma and poor health .…”

Section: Introductionmentioning

confidence: 99%

Strong independent association between obesity and essential hypertension

et al. 2016

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Obesity and hypertension (HTN) are major risk factors for cardiovascular disease. Association between obesity and HTN has not been studied in a large populations following adjustment for comorbidities. The goal of this study was to evaluate any association between obesity and HTN after adjusting for baseline characteristics. We used ICD-9 codes for obesity and HTN from the Nationwide Inpatient Sample (NIS) databases. Two randomly selected years, 1992 and 2002, were chosen from the databases as two independent samples. We used uni- and multivariable analysis to study any correlation between obesity and HTN. The 1992 database contained a total of 6,195,744 patients. HTN was present in 37.2 % of patients with obesity versus 12% of the control group (OR: 4.36, CI 4.30-4.42, P < 0.001). The 2002 database contained a total of 7,153,982 patients. HTN was present in 50.7% of patients with obesity versus 25.6% of the control group (OR: 2.98, CI 2.96-3.00, P < 0.001). Using multivariable analysis adjusting for gender, hyperlipidaemia, age, smoking, type 2 diabetes and chronic renal failure, obesity remained correlated with HTN in both years (1992: OR 2.69, CI 2.67-2.72, P < 0.001; 2002: OR 2.98, CI 2.96-3.00, P < 0.001). The presence of obesity was found to be strongly and independently associated with HTN. The cause of this correlation is not known warranting further investigation.

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Impact of race and obesity on arterial endothelial dysfunction associated with sleep apnea: Results from the Heart SCORE study

Cited by 7 publications

References 10 publications

Correlates of Endothelial Function in Older Adults With Untreated Obstructive Sleep Apnea and Cardiovascular Disease

Correlates of Endothelial Function in Older Adults With Untreated Obstructive Sleep Apnea and Cardiovascular Disease

Association between obstructive sleep apnea severity and endothelial dysfunction in patients with type 2 diabetes

Strong independent association between obesity and essential hypertension

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