Xuting Zhang1, Jiayao Fan2, Yeli Guo3, Jinjian Zhou1, Fei Chen1, Zhigang Jin1, Yingjun Li4. 1. Zhuji People's Hospital of Zhejiang Province, Zhuji Affiliated Hospital of Shaoxing Univesity, Zhuji, China. 2. School of Public Health, Hangzhou Medical College, Hangzhou, China. 3. Traditional Chinese Medical Hospital of Zhuji, Zhuji, China. 4. School of Public Health, Hangzhou Medical College, Hangzhou, China. Electronic address: yingjunguqing2006@126.com.
Abstract
OBJECTIVE: The aim of this study was to summarize the evidence concerning the relationship between obstructive sleep apnoea syndrome (OSAS) and the risk of cardiovascular diseases (CVDs). METHODS: A systematic search was carried out using PubMed and Web of Science up to September 10, 2019. Categorical as well as linear and non-linear dose-response meta-analyses were respectively performed to evaluate the association between the severity of OSAS and the risk of CVDs. Apnoea-hypopnea index (AHI) was used as an indicator of OSAS severity. RESULTS: This study included 10 cohort studies targeting a total of 36,347 subjects and 3362 patients with CVDs. The pooled RRs of overall CVDs were 1.13 (95% confidence interval [CI] = 1.02-1.24) for mild versus non/normal OSAS, 1.16 (95% CI = 1.02-1.32) for moderate versus non/normal OSAS, 1.26 (95% CI = 1.15-1.39) for moderate-severe versus non/normal OSAS, and 1.41 (95% CI = 1.22-1.63) for severe versus non/normal OSAS. The linear dose-response meta-analysis showed that every 10 events/hour increment in AHI value was associated with a 9% increased risk of suffering from CVDs. The non-linear dose-response meta-analysis showed that the risk of CVDs increased continuously with the increment in AHI. CONCLUSION: The present systematic review and meta-analysis provide evidence for a positive association between OSAS and the risk of CVDs, despite the severity of OSAS. The relative risk of CVDs increases continuously with the increment in AHI.
OBJECTIVE: The aim of this study was to summarize the evidence concerning the relationship between obstructive sleep apnoea syndrome (OSAS) and the risk of cardiovascular diseases (CVDs). METHODS: A systematic search was carried out using PubMed and Web of Science up to September 10, 2019. Categorical as well as linear and non-linear dose-response meta-analyses were respectively performed to evaluate the association between the severity of OSAS and the risk of CVDs. Apnoea-hypopnea index (AHI) was used as an indicator of OSAS severity. RESULTS: This study included 10 cohort studies targeting a total of 36,347 subjects and 3362 patients with CVDs. The pooled RRs of overall CVDs were 1.13 (95% confidence interval [CI] = 1.02-1.24) for mild versus non/normal OSAS, 1.16 (95% CI = 1.02-1.32) for moderate versus non/normal OSAS, 1.26 (95% CI = 1.15-1.39) for moderate-severe versus non/normal OSAS, and 1.41 (95% CI = 1.22-1.63) for severe versus non/normal OSAS. The linear dose-response meta-analysis showed that every 10 events/hour increment in AHI value was associated with a 9% increased risk of suffering from CVDs. The non-linear dose-response meta-analysis showed that the risk of CVDs increased continuously with the increment in AHI. CONCLUSION: The present systematic review and meta-analysis provide evidence for a positive association between OSAS and the risk of CVDs, despite the severity of OSAS. The relative risk of CVDs increases continuously with the increment in AHI.