Abstract 17849: Association of Obstructive Sleep Apnea With Endothelial Dysfunction, Arterial Stiffness, and Markers of Subclinical Atherosclerosis
Introduction: Studies have reported associations between obstructive sleep apnea (OSA) and cardiovascular disease (CVD) outcomes. Proposed mechanisms include endothelial dysfunction and increased arterial stiffness.
Methods: We used data from the community-based Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study to investigate the association of OSA with vascular function and markers of subclinical atherosclerosis. OSA severity was measured in 833 individuals using the apnea-hypopnea index (AHI). Endothelial dysfunction and arterial stiffness were measured using the Endo-PAT device, expressed as Framingham reactive hyperemia index (fRHI) and heart rate-adjusted augmentation index (AI75), respectively. Coronary artery calcium (CAC) and carotid intima-media thickness (CIMT) were quantified using electron beam computed tomography and carotid ultrasonography, respectively. Cross-sectional associations of OSA were assessed using linear regression models. Adjustment was made for traditional CVD risk factors.
Results: 554 (67%) participants were female, 314 (38%) were Black, and 214 (25%) had moderate-severe OSA (AHI ≥ 15). In a univariate model, OSA was directly associated with CAC, CIMT, and several traditional CVD risk factors, and inversely associated with fRHI, female sex, and HDL-cholesterol. Individuals with moderate-severe OSA had lower fRHI and higher CAC, which remained borderline significant in the fully adjusted models (p=0.08 for both). In contrast, the associations for AI75 and CIMT were not statistically significant in the multivariable models.
Conclusion: In a community-based cohort, moderate-severe OSA was modestly associated with some markers of vascular dysfunction and subclinical atherosclerosis (i.e., fRHI and CAC), but not others (AI75 and CIMT). Further large multiracial studies assessing vascular function are needed to further elucidate the mechanism of OSA’s effect on CVD.
Author Disclosures: D. Shpilsky: None. O. Ajala: None. S. Erqou: None. O. Olafiranye: None. K. Kip: None. A. Aiyer: None. S. Reis: None.
- © 2016 by American Heart Association, Inc.