Risk prediction of atherosclerotic cardiovascular disease of patients with obstructive sleep apnea hypopnea syndrome

  Objective  To evaluate the 10-year risk and lifetime risk of atherosclerotic cardiovascular disease(ASCVD)of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and furthermore to carry out the primary prevention of cardiovascular and cerebrovascular diseases.

  Methods  Totally 248 patients with snoring symptoms screened by regular physical examination from January to December 2020 were studied. Grade Ⅲ portable sleep monitoring was used to diagnose OSAHS and parameters such as apnea hypopnea index(AHI)and percentage of blood oxygen less than 90% in total monitoring time (TS90%) were recorded. According to AHI data, the subjects were divided into simple snoring group (51 cases), mild OSAHS group (79 cases), moderate OSAHS group(79 cases), and severe OSAHS group(39 cases). Multiple linear regression was used to analyze the association between OSAHS sleep parameters and ASCVD risk score under China PAR model.

  Results  The age of OSAHS patients was higher than that of simple snoring group and the risk of OSAHS in men was higher(P < 0.05). The waist circumference of OSAHS patients was thicker and increased with OSAHS severity increasing(P < 0.05). The proportion of OSAHS complicated with hypertension, the systolic and diastolic blood pressure were higher than patients in simple snoring group(P < 0.05). The score of China PAR in OSAHS group was significantly higher than that in simple snoring group(P < 0.05). The higher the degree of OSAHS the higher the lifetime risk of ASCVD (P < 0.05). The results of regression analysis showed that: (1)for every 1% increase in TS90 % the annual risk of ASCVD 10 increased by 0.114 (P = 0.007); (2) The lifetime risk of ASCVD increased by 0.373 and 0.131 when TS90% increased by 1% and AHI increased once an hour respectively(P < 0.001).

  Conclusion  OSAHS is closely related to cardiovascular and cerebrovascular risk. The patients with moderate and severe OSAHS should pay more attention to the lifelong risk of cardiovascular and cerebrovascular disease. We should care the OSAHS patients' time when blood oxygen saturation is less than 90% during overnight sleep. TS90% is an independent risk factor for 10-year cardiovascular risk and lifelong risk and it may be a biomarker of effectiveness for early intervention of OSAHS.