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The effect of obstructive sleep apnea on the increased risk of cardiovascular disease: a systematic review and meta-analysis

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Abstract

Background

Obstructive sleep apnea (OSA) is a disorder characterized by intermittent airway obstruction during sleep. The association between OSA and the incidence of cardiovascular disease (CVD) has been investigated in many studies; however, the results are not entirely consistent between studies. The aim of this study was to investigate the relationship between OSA and the risk of CVD through a meta-analysis of cohort studies.

Methods

A systematic review and meta-analysis of literature was conducted using the PubMed, WoS, Embase, ScienceDirect, Scopus, and Web of Science databases up to the year 2020. In order to analyze the eligible studies, the stochastic effects model was used and the heterogeneity of the studies with the I2 index was investigated. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2).

Results

A total of 24 studies were included in the meta-analysis according to the inclusion criteria. Twelve studies reported CVD results, 11 studies reported stroke results, 9 studies reported mortality results, and 8 studies reported CVD results. The odds ratio of CVD in patients with OSA 1.71 (1.17–2.27: 95% confidence interval) stroke in patients with OSA, 1.86 (1.28–2.69: 95% confidence interval), mortality in patients with OSA, 1.77 (1.37–2.29: 95% confidence interval) and CHD in patients with OSA, and 1.48 (1.06–2.28: 95% confidence interval) was obtained.

Conclusion

OSA is considered a cardiovascular risk factor. There is a relationship between the severity of OSA and the risk of cardiovascular disease. OSA increases the risk of heart attack, CHD, and death from cardiovascular disease.

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Availability of data and materials

Datasets are available through the corresponding author upon reasonable request.

Abbreviations

AHI:

Apnea hypopnea index

CHD:

Coronary heart disease

CVD:

Cardiovascular disease

OD:

Oxygen desaturation

ODI:

Oxygen desaturation index

PSG:

Polysomnography

AFatrial fi:

Brillation

BMI:

Body mass index

CHF:

Congestive heart failure

DBP:

Diastolic blood pressure

DM:

Diabetes mellitus

ESS:

Epworth Sleepiness Scale

HDL:

High-density lipoprotein

HTN:

Hypertension

MI:

Myocardial infarction

SBP:

Systolic blood pressure

LVH:

Left ventricular hypertrophy

COPD:

Chronic obstructive pulmonary disease

BUN:

Blood urea nitrogen

FEV:

Forced expiratory volume

MACCE:

Major adverse cardiovascular and cerebrovascular event.

WoS:

Web of Science

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Acknowledgements

This study is the result of research project no. 3011583 approved by the Student Research Committee of Kermanshah University of Medical Sciences. We would like to thank the esteemed officials of the center for the financial affords of this study.

Funding

This study received financial support from Deputy for Research and Technology, Kermanshah University of Medical Sciences (IR) (3011583).

Author information

Authors and Affiliations

  1. Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Nader Salari, Habibolah Khazaie & Behnam Khaledi-Paveh

  2. Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Maryam Abolfathi

  3. Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Hooman Ghasemi, Shervin Shabani, Shna Rasoulpoor & Shabnam Rasoulpoor

  4. Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran

    Masoud Mohammadi

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  1. Nader Salari
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Contributions

ND and HKH and MA and SHR contributed to the design; MM statistical analysis, participated in most of the study steps. HGH and SHSH and SHAR prepared the manuscript. MM and SHAR assisted in designing the study, and helped in the interpretation of the study. All authors have read and approved the content of the manuscript.

Corresponding author

Correspondence to Masoud Mohammadi.

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This deputy has no role in the study process.

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Ethics approval was received from the ethics committee of deputy of research and technology, Kermanshah University of Medical Sciences (3011583).

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Not applicable.

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The authors declare no competing interests.

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Salari, N., Khazaie, H., Abolfathi, M. et al. The effect of obstructive sleep apnea on the increased risk of cardiovascular disease: a systematic review and meta-analysis. Neurol Sci 43, 219–231 (2022). https://doi.org/10.1007/s10072-021-05765-3

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