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Carotid Intima Media Thickness in Patients with Obstructive Sleep Apnea: Comparison with a Community-Based Cohort

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Abstract

Background

The impact of obstructive sleep apnea (OSA) on the development of atherosclerotic cardiovascular disease (CVD) in the absence of overt CVD or risk factors is unclear. Our purpose was to assess whether patients with OSA without overt CVD or risk factors have subclinical atherosclerosis as evaluated by carotid intima medial thickness (CIMT) compared to matched controls.

Methods

We measured CIMT in patients >40 years old, who underwent polysomnography for suspected OSA and did not have a history of CVD or risk factors (smoking, hypertension, diabetes, hyperlipidemia). OSA severity was classified according to apnea–hypopnea index. Serum levels of high-sensitivity C-reactive protein, fibrinogen, and lipids were assessed and relationships with OSA severity explored. CIMT measurements from patients with OSA were compared those of to age-, gender-, and BMI-matched controls from a community-based cohort without known CVD or OSA.

Results

Fifty-one patients were studied. Of these, patients with severe OSA had an increased CIMT compared to patients without OSA, but the relationship was not significant after controlling for age (p = 0.10). However, 37 patients had OSA and were matched to 105 controls. CIMT was significantly increased in OSA patients versus controls (0.77 vs. 0.68 mm, p = 0.03). The difference between patients and controls was greater for patients with severe OSA (0.83 vs. 0.71 mm) than for patients with mild-to-moderate OSA (0.71 vs. 0.67 mm).

Conclusions

Patients with OSA but without a history of or risk factors for CVD have increased CIMT compared to a BMI-, age-, and gender-matched cohort. This provides evidence that OSA is an independent risk factor for the development of CVD.

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Acknowledgments

This study was funded by an operating grant from the Vancouver General Hospital Division of Cardiology CV Research Fund, and a Canadian Institutes of Health Research (CIHR) Sleep Team Grant. The M-CHAT cohort study was funded by CIHR. Dr. Ayas was supported by an Established Clinician Scientist Award from Vancouver Coastal Health Research Institute. Dr. Lear is the Pfizer/Heart and Stroke Foundation Chair in Cardiovascular Prevention Research at St. Paul’s Hospital.

Conflict of interest

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada

    Nurit Fox, Najib Ayas, John Fleetham & C. Frank Ryan

  2. Division of Critical Care Medicine, University of British Columbia, Vancouver, BC, Canada

    Najib Ayas

  3. Providence Health Care Research Institute, Vancouver, BC, Canada

    Julie E. Park

  4. Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada

    Scott A. Lear

  5. Division of Cardiology, Providence Health Care, Vancouver, BC, Canada

    Scott A. Lear

  6. Department of Respiratory Medicine, Bonsecours Hospital, Tralee, County Kerry, Ireland

    Alan Mulgrew

  7. Division of Cardiology, University of British Columbia, Level 9 – 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada

    Sammy Chan, G. B. John Mancini & Graham C. Wong

  8. Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada

    John Hill

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  1. Nurit Fox
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  2. Najib Ayas
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  10. G. B. John Mancini
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Corresponding author

Correspondence to Graham C. Wong.

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Fox, N., Ayas, N., Park, J.E. et al. Carotid Intima Media Thickness in Patients with Obstructive Sleep Apnea: Comparison with a Community-Based Cohort. Lung 192, 297–303 (2014). https://doi.org/10.1007/s00408-014-9556-y

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  • DOI: https://doi.org/10.1007/s00408-014-9556-y

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