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Continuous positive airway pressure treatment improves cardiovascular outcomes in elderly patients with cardiovascular disease and obstructive sleep apnea

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Abstract

Obstructive sleep apnea (OSA) is associated with the progression of cardiovascular disease (CVD), particularly in the middle-aged population. However, the clinical importance of OSA as a risk for CVD in the elderly population remains controversial. Moreover, evidence for the effectiveness of continuous positive airway pressure (CPAP) treatment for the secondary prevention of CVD in elderly patients is lacking. We assessed whether CPAP treatment improves cardiovascular outcomes in elderly patients with OSA and CVD. In this retrospective cohort study, we enrolled 130 elderly patients aged 65–86 years with moderate to severe OSA (apnea–hypopnea index ≥15/h) and a history of hospitalization due to CVD, who underwent polysomnography between November 2004 and July 2011. Patients were divided into the CPAP group (n = 64) or untreated OSA group (n = 66). The main outcome measures were cardiovascular death and hospitalization due to CVD. During the mean follow-up period of 32.9 ± 23.8 (standard deviation) months, 28 (21.5 %) patients either died or were hospitalized. The Kaplan–Meier curves indicated that event-free survival was significantly lower in the untreated OSA group than in the CPAP group (P < 0.005). A multivariate analysis showed that the risk was significantly increased in the untreated OSA group (hazard ratio 5.13; 95 % confidence interval 1.01–42.0; P < 0.05). Moderate to severe OSA not treated with CPAP was an independent risk factor for relapse of a CVD event, and adequate CPAP treatment improved cardiovascular outcomes in elderly patients.

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Acknowledgments

The authors thank Ryoko Asanuma for excellent technical support. The authors are indebted to Associate Professor Edward F. Barroga (DVM, PhD) of the Department of International Medical Communications of Tokyo Medical University for the editorial review of the English manuscript. The authors have received no grant support for this study.

Conflict of interest

The authors declare no potential conflicts of interest associated with this study.

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Authors and Affiliations

  1. Department of Cardiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Yosuke Nishihata, Yoshifumi Takata, Yasuhiro Usui, Kota Kato, Tasuku Yamaguchi, Kazuki Shiina & Akira Yamashina

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  1. Yosuke Nishihata
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  2. Yoshifumi Takata
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  3. Yasuhiro Usui
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Correspondence to Yoshifumi Takata.

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Nishihata, Y., Takata, Y., Usui, Y. et al. Continuous positive airway pressure treatment improves cardiovascular outcomes in elderly patients with cardiovascular disease and obstructive sleep apnea. Heart Vessels 30, 61–69 (2015). https://doi.org/10.1007/s00380-013-0451-x

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