Obstructive sleep apnea is independently associated with subclinical coronary atherosclerosis among middle-aged women

• Published in: Sleep & breathing 2017-03, Vol.21 (1), p.77-83
• Main Authors: Medeiros, Ana Kelley L., Coutinho, Ricardo Q., Barros, Isly M. L., Costa, Laura O. B. F., Leite, Ana Paula D. L., Bittencourt, Marcio S., Lustosa, Thais C., Carvalho, Martinha M. B., Lira, Maria Priscila Figueiredo, Ferreira, Moacir N. L., Lorenzi-Filho, Geraldo, Drager, Luciano F., Pedrosa, Rodrigo P.
• Format: Article
• Language: English
• Subjects: Airway management; Atherosclerosis; Blood pressure; Body mass index; Cardiovascular disease; Cholesterol; Cohort Studies; Coronary Artery Disease - diagnosis; Coronary Artery Disease - epidemiology; Coronary vessels; Dentistry; Diabetes; Exercise; Female; Heart failure; Hormone replacement therapy; Hospitals; Humans; Hypertension; Internal Medicine; Medicine; Medicine & Public Health; Menstruation; Middle age; Middle Aged; Mortality; Neurology; Otorhinolaryngology; Overweight - diagnosis; Overweight - physiopathology; Pediatrics; Pneumology/Respiratory System; Questionnaires; Regression analysis; Risk Factors; Selenic Acid; Sex Factors; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Sleep Breathing Physiology and Disorders • Original Article; Statistics as Topic; Vascular Calcification - diagnosis; Vascular Calcification - epidemiology; Veins & arteries; Womens health
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-016-1374-4

Purpose Obstructive sleep apnea (OSA) is associated with coronary disease among men. However, this association is not clear for women. In this study, we evaluate the association between OSA and presence of subclinical atherosclerosis assessed by tomographic coronary calcium score in middle-aged women. Methods We evaluated consecutive women aged between 45 and 65 years in perimenopause or postmenopause period (with menstrual irregularity—amenorrhea > 60 days), without manifest cardiovascular disease (heart failure, coronary disease, and stroke), from two gynecologic clinics. All patients underwent clinical evaluation, computed tomographic examination for coronary artery calcium (CAC > 100 Agatston units), and portable sleep study. Multiple logistic regression models were used to evaluate the association between OSA and CAC, controlling for traditional risk factors including Framingham Risk Score (FRS), body mass index (BMI), and diabetes. Results We studied 214 women (age 56 years (52–61); BMI 28 kg/m 2 (25–31), 25 % diabetes, 62 % hypertension). OSA (apnea-hypopnea index (AHI) ≥5 events/h) was diagnosed in 82 women (38.3 %). CAC was more prevalent in patients with moderate/severe OSA (AHI ≥15 events/h) than in patients without or with mild OSA, 19 % vs 4.5 and 1.6 %, respectively ( p