Influence of Comorbidity and Obesity on the Occurrence of Vascular Events in Obstructive Apnoea Treated with CPAP.

ABSTRACT

BACKGROUND: Obesity has increased cardiovascular morbidity and mortality. It is the leading risk factor for obstructive sleep apnoea (OSA). The relationship between obesity-OSA and vascular disease seems clear. There is no consensus on whether CPAP (continuous positive airway pressure) treatment prevents vascular events. OBJECTIVE: The aim of this study was to determine the effect of comorbidity and obesity on the risk of vascular events in patients with OSA treated with CPAP. METHOD: This study was a prospective study of historical cohorts of adult patients with OSA and CPAP. The sample was 3017 patients. Descriptive, survival (Kaplan-Meier) and Cox regression analyses were performed, calculating crude and adjusted association relationships to explain the risk of vascular events. RESULTS: A total of 1726 patients were obese, 782 were diabetics, and 1800 were hypertensive. The mean adherence was 6.2 (±1.8 h/day), and the mean follow-up time was 2603 days (±953.3). In the COX regression analysis, the event-related variables were baseline age (HR 1.025 1.012-1.037; p < 0.001), pre-treatment vascular event (HR; 2.530 1.959-3.266; p < 0.001), hypertension (HR; 1.871 1.187-2.672; p = 0.005) and abbreviated Charlson comorbidity index (HR; 1.289 1.100-1.510; p = 0.002). CONCLUSIONS: The occurrence of vascular events in OSA patients on CPAP treatment is related to hypertension, having a vascular event before treatment, age at the start of CPAP use and abbreviated Charlson comorbidity index.