Rofo 2012; 184 - KOH11
DOI: 10.1055/s-0031-1300898

Association of Sleep-disordered Breathing and Subclinical Coronary Atherosclerosis in the General Population – Results of the Heinz Nixdorf Recall Study

G Weinreich 1, T Wessendorf 1, T Erdmann 1, S Moebus 2, N Dragano 2, N Lehmann 2, A Stang 3, U Roggenbuck 2, M Bauer 4, KH Jöckel 2, R Erbel 4, H Teschler 1, S Möhlenkamp 4
  • 1Ruhrlandklinik, Pneumologie, Essen
  • 2Universitätsklinik Essen, Institut für Medizinische Informatik, Biometrie und Epidemiologie, Essen
  • 3Universitätsklinikum Halle, Institut für Klinische Epidemiologie, Halle
  • 4Universitätsklinik Essen, Klinik für Kardiologie, Essen

Background:

There is increasing evidence for the role of sleep-disordered breathing (SDB), particularly obstructive sleep apnea, as a risk factor for atherosclerosis.

Objectives:

This study aimed to determine the prevalence of SDB in the general population and to analyze the association of SDB with traditional cardiovascular disease risk factors and subclinical coronary atherosclerosis.

Methods:

An unselected subgroup of subjects underwent screening for SDB. We used ApneaLink (ResMed, Sydney, Australia) for recording airflow during sleep in the Heinz Nixdorf Recall study, a large ongoing epidemiological trial, in which subclinical atherosclerosis is evaluated by electronic beam computer tomography (EBCT). Analysis of the device was visually controlled, and data with obvious artefacts or short recording time (<2h) were disregarded. The automatically generated apnea-hypopnea index (AHI) was correlated to the Agatston score for coronary artery calcification (CAC) and other risk factors. CAC was compared among participants with increasing severity of SDB.

Results:

Data are available for 1524 subjects (759 men, 765 women, aged 64±7 years (range 50–80 years), BMI 28.0±4.2kg/m2). SDB, defined by AHI ≥15/h, was observed in 29.1% of men and 15.6% of women (overall: 22.3%). SDB prevalence increased with age both in men and in women. Median CAC scores increased significantly (p<0.001) in men with the severity of SDB: 49 for no SDB (AHI<5/h), 83 for mild SDB (AHI 5–14/h), 134 for moderate SDB (AHI 15–29/h) and 165 for severe SDB (AHI ≥30/h). In women increase of median CAC scores was also significant (p<0.001): 0 for no SDB, 2 for mild SDB, 8 for moderate SDB and 40 for severe SDB, respectively. Multiple linear regression analysis showed that age, sex, hypertension, LDL cholesterol, smoking status and log-transformed AHI were independently associated with log-transformed CAC.

Conclusions:

In the general population aged >50 years, AHI is associated with subclinical atherosclerosis independent of traditional cardiovascular risk factors.