Traditional risk factors of atherosclerosis in patients with obstructive sleep apnoe-hypopnoe syndrome

Czech version

Authors: E. Szabóová ¹; Z. Tomori ²; J. Gonsorčík ¹; J. Petrovičová ³
Authors‘ workplace: IV. interná klinika Lekárskej fakulty UPJŠ a FN L. Pasteura Košice, Slovenská republika, prednosta prof. MUDr. Ivan Tkáč, Ph. D. ¹; Ústav fyziológie Lekárskej fakulty UPJŠ Košice, Slovenská republika, prednosta prof. MUDr. Viliam Donič, CSc. ²; Ústav lekárskej informatiky Lekárskej fakulty UPJŠ Košice, Slovenská republika, prednosta Ing. Jaroslav Majerník, Ph. D. ³
Published in: Vnitř Lék 2008; 54(4): 352-360
Category: Original Contributions

Overview

Cardiovascular morbidity and mortality of patients with obstructive sleep apnoe-hypopnoe syndrome (OSAHS) is higher than in matched population.

The aim of the study was to analyse, whether high prevalence of risk factors of atherosclerosis in patients with OSAHS can explaine their higher cardiovascular morbidity.

Methods:
2 groups of 33 males with moderate OSAHS and l6 males without OSAHS were subdivided into subgroups of apparently healthy subjects, hypertonics and patients with coronary artery disease. We compared the presence of traditional risk factors of atherosclerosis (age, hyperlipoproteinaemia, diabetes mellitus, arterial hypertension, obesity, smoking habit, obesity, family history), compensation of metabolic risk factors, morphometry of the heart, haemodynamic parameters, markers of atherosclerosis, microalbuminuria and some respiratory parameters.

Results:
Patients with/without OSAHS had a comparable risk profile at all grades of cardiovascular pathology, they differed only in respiratory parameters (characteristic for OSAHS). Moreover, OSAHS patients without cardiovascular diseases vs. matched nonOSAHS subjects had higher thickness of posterior wall of the left ventricule (9.73 ± 1.17 vs 8.29 ± 1,38 mm, p < 0.04), intima-media thickness of carotid artery (0.83 ± 0,14 vs 0.63 ± 0.08 mm, p < 0.00l) and OSAHS patients with hypertension vs nonOSAHS hypertonics presented higher dimension of right ventricule (28.4 ± 2.7 vs 26.25 ± 0.96 mm, p < 0.02), and left ventricule (47.6 ± 3.3 vs 43.75 ± 0.96 mm, p < 0.01).

Conclusion:
Patients with OSAHS had severe atherosclerosis and worse morphological alteration of the heart compared to subjects without OSAHS. According to comparable presence and possibility of sufficient control of risk factors, OSAHS can be considered to be a risk factor for cardiovascular diseases. However, this statement has to be further confirmed in prospective studies.

Key words:
obstructive sleep apnoe - atherosclerosis - risk factors - cardiovascular morbidity and mortality

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