Obstructive Sleep Apnea and Aging Effects on Macrovascular and Microcirculatory Function

Yim-Yeh, Susie; Rahangdale, Shilpa; Nguyen, Anh Tu Duy; Jordan, Amy S.; Novack, Victor; Veves, Aristidis; Malhotra, Atul

doi:10.1093/sleep/33.9.1177

Cited by 42 publications

(37 citation statements)

References 40 publications

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“…Obesity and aging are probably crucial factors in the United States, and the rising trend of these two factors requires more attention to this context. 17,18 Although the prevalence of risky apnea in the present study was similar to findings in Pakistan (10-12%), 19 it was more common in Malaysia (15.2%). 20 On the other hand, rates if 3.5% and 6.1% were reported in France and Turkey, respectively.…”

Section: Discussionsupporting

confidence: 82%

“…[24][25][26] This has been confirmed in several studies. 1,8,[10][11][12][13]17 For example, obese individuals presented a risk of OSAS that was 10 times higher in the study by Salvador et al 27 There was also a strong relationship between these in the presence of confounding variables. On the basis of several studies, increased body weight can alter the normal upper airway mechanics during sleep through a variety of distinct mechanisms.…”

Section: Discussionmentioning

confidence: 99%

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Obstructive sleep apnea syndrome: complaints and housing characteristics in a population in the United States

Ansarin

Sahebi

2013

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) is one of the leading causes of morbidity and mortality in adults. Early detection of the disorder and discovery of risk factors through standardized questionnaires will lead to reduction of the OSAS burden. The main aim of this study was to estimate the prevalence of OSAS symptoms and examine their association with housing characteristics. DESIGN AND SETTING: Cross-sectional study at a medical school. METHODS: Demographic, housing and body measurement data on 5,545 individuals aged 16 years and over of various races were selected from the National Health and Nutrition Examination Survey. We analyzed the probability of OSAS based on habitual snoring combined with daytime sleepiness and/or witnessed apnea. Univariate and multiple linear regression were used. RESULTS: 9.8% of the men and 6.9% of the women reported symptoms suggestive of OSAS (habitual snoring, daytime sleepiness and/or apnea). The following prevalences of symptoms were found among males and females respectively: frequent snoring 35.1%, 22.3%, excessive daytime sleepiness 6.4%, 3.4% and frequent apnea 14.9%, 20.6%. Using multiple linear regression, OSAS symptoms were correlated with gender, age, body mass index (BMI), marital status and education. Regarding housing characteristics, mildew or musty smell and pets in the environment were associated with a high probability of OSAS. CONCLUSION: OSAS symptoms were more prevalent than in developing countries. The environment was an important risk factor, but environmental factors are easier to control and manage than other variables like BMI or socioeconomic status. RESUMO

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea syndrome: complaints and housing characteristics in a population in the United States

Ansarin

Sahebi

2013

Sao Paulo Med. J.

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“…This finding is consistent with those from previous studies. [25][26][27][28] Although the 6 risk factors had no further influence on endothelial function after adjusting for covariates, MetS remains a significant and independent determinant of endothelial function.…”

Section: Discussionmentioning

confidence: 93%

Comparison of the Effect of the Metabolic Syndrome and Multiple Traditional Cardiovascular Risk Factors on Vascular Function

Flammer

Lennon

et al. 2012

Mayo Clinic Proceedings

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Objective: To assess the effect of the metabolic syndrome (MetS) on endothelial function and compare these findings to those in individuals with a similar burden of traditional cardiovascular (CV) risk factors (Ն3) without MetS. Patients and Methods: Both MetS and multiple CV risk factors were identified from 1103 individuals who underwent the evaluation of endothelial function at the Mayo Clinic, in Rochester, Minnesota, from July 1, 2000, through July 31, 2011. Endothelial function was measured using digital arterial tonometry by assessing reactive hyperemia-induced vasodilation in one arm and adjusting for changes in the contralateral arm (reactive hyperemia index [RHI]). Results: A total of 316 individuals with MetS and 210 with multiple risk factors were assessed. Endothelial dysfunction was more pronounced in the MetS group compared with the multiple risk factor group (mean Ϯ SD natural logarithmic RHI, 0.61Ϯ0.25 and 0.68Ϯ0.28, respectively; Pϭ.006). Leukocyte count (7.00Ϯ1.89 ϫ 10 9 /L vs 6.41Ϯ1.76 ϫ 10 9 /L, respectively; Pϭ.001) and high-sensitivity C-reactive protein level (1.78Ϯ1.53 mg/L vs 1.48Ϯ1.42 mg/L, respectively; Pϭ.01) were higher in the MetS group compared with the multiple risk factor group. After adjustment for covariates and 6 traditional CV risk factors in a multivariate regression model, MetS had a significant and independent influence on natural logarithmic RHI (␤ϭϪ.11; Pϭ.01). Conclusion: The current study found that individuals with MetS have a higher degree of endothelial dysfunction and inflammation compared with individuals with multiple CV risk factors and may therefore have an increased CV risk beyond the contributions of multiple traditional risk factors.

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“…Yim-Yeh et al 23) reported that both OSA and aging impair the endothelial function and increase arterial stiffness in patients with obesity. Although that study included patients with OSA, the mean patient age was lower (mean age: 40 versus 60 years of age) and the mean BMI was higher (37 kg/m 2 versus 24 kg/m 2 ) than that observed in our population.…”

Section: Resultsmentioning

confidence: 99%

“…The measurement of CAVI has demonstrated good reproducibility and was not affected by the blood pressure during measurement 17,18) . To date, the majority of studies linking OSA to arterial stiffness recruited participants from sleep clinic patients [19][20][21] , there have been only two communitybased studies 22,23) , which also recruited patients with sleep disorder breathing and their methodology to measure arterial stiffness was different to CAVI.…”

Section: Assessment Of Nihmentioning

confidence: 99%

Relationships between Nocturnal Intermittent Hypoxia, Arterial Stiffness and Cardiovascular Risk Factors in a Community-based Population: The Toon Health Study

Alberto

Tanigawa

Maruyama

et al. 2014

JAT

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Aim: Nocturnal intermittent hypoxia (NIH), a primary marker of obstructive sleep apnea, has increasingly been linked with cardiovascular morbidity and mortality. The purpose of this study was to investigate the association between NIH and arterial stiffness as measured according to the cardio-ankle vascular index (CAVI) based on cardiovascular risk factors in a Japanese community-dwelling population. Methods: We conducted a cross-sectional study in Toon city among 684 men and 1,241 women 30-79 years of age. The severity of NIH was defined as mild or moderate-to-severe according to five or 15 events/hour on the 3% oxygen desaturation index (ODI), respectively. Increased arterial stiffness was diagnosed according to a CAVI of ≥ 9. Results: The number of subjects with no, mild and moderate-to-severe NIH was 1,348 (70%), 451 (23%) and 126 (7%), respectively. Increased arterial stiffness was detected in 21.9% of the participants. The multivariable-adjusted odds ratio (95% CI) of severe NIH related to an increased CAVI in comparison with a 3% ODI of ＜5 was 1.36 (0.82-2.23). The stratified logistic regression analysis showed that the multivariable-adjusted OR of severe NIH for an increased CAVI was remarkably increased in the individuals with a BMI of ≥ 25 (OR = 2.53, 1.08-5.96; p = 0.03). An interaction test showed a trend for an overweight status to be a modifier of the association between OSA and increased arterial stiffness (p = 0.05). Conclusions: NIH has a tendency to promote increased arterial stiffness as measured according to the CAVI, especially in overweight subjects.

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Obstructive Sleep Apnea and Aging Effects on Macrovascular and Microcirculatory Function

Cited by 42 publications

References 40 publications

Obstructive sleep apnea syndrome: complaints and housing characteristics in a population in the United States

Obstructive sleep apnea syndrome: complaints and housing characteristics in a population in the United States

Comparison of the Effect of the Metabolic Syndrome and Multiple Traditional Cardiovascular Risk Factors on Vascular Function

Relationships between Nocturnal Intermittent Hypoxia, Arterial Stiffness and Cardiovascular Risk Factors in a Community-based Population: The Toon Health Study

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