Obstructive sleep apnea frequent in pulmonary hypertension

January 18, 2022

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In a new study, researchers reported that obstructive sleep apnea is common in patients with pulmonary hypertension, and risk factors include older , male gender, and lower diurnal arterial oxygen pressure.

This single-center, observational study enrolled 140 patients with pulmonary hypertension (mean , 39.5 years; 76.4% female) diagnosed by right heart catheterization who underwent overnight cardiorespiratory monitoring from December 2018 to December 2020. OSA was defined by an apnea-hypopnea index of 5 or more hours with 50% or more obstructive apnea events. The researchers then compared patients with pulmonary hypertension with and without OSA.

Data were derived Yan L et al. BMC Pulm Med. 2021;doi:10.1186/s12890-021-01755-5.

Twenty-five percent of patients with pulmonary hypertension had OSA. The incidence of OSA was 76% in patients with pulmonary hypertension associated with lung disease or low oxygen, 50% in patients with chronic thromboembolic pulmonary hypertension, 15.4% in patients with connective tissue disease-associated PAH, 11.8% in patients with unknown Mechanisms of pulmonary hypertension and 8% in patients with congenital heart disease-associated PAH.

Most patients with OSA were male (42.9% vs. 17.1%; p=0.001), older (46.7 years vs. 37 years; p=0.001), and had lower daytime arterial oxygen pressure (63.69 mmHg vs. 71.77 mmHg). ; P=0.014) compared to patients without OSA.

(OR=1.039; 95% CI, 1.005-1.975; p=0.025), female gender (OR=0.288; 95% CI, 0.112-0.738; p=0.01), systolic blood pressure (OR=1.03; 95). %CI, 0.998-1.064; p=0.068) and diurnal arterial oxygen pressure (OR=0.965; 95% CI, 0.931-1; p=0.049) were associated with OSA in patients with pulmonary hypertension in a multivariate logistic regression analysis after correcting for BMI, consistent with the results.

In addition, older age, male gender and lower daytime arterial oxygen pressure had the strongest ability to indicate OSA in this patient population, the researchers wrote.

“OSA has a high incidence in patients with pulmonary hypertension. OSA can exacerbate pulmonary hypertension to some extent, and advanced age, male gender, and lower daytime PaO2 might predict the presence of OSA. It may be important to identify and treat patients with pulmonary hypertension with OSA,” Dr. Lu Yan from the Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Beijing Union Medical College, Beijing and colleagues wrote in BMC Pulmonary Medicine. “The clinical importance of pulmonary hypertension in OSA requires further investigation.”

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