The Risk Of Cardiovascular Damage In Patients With Obstructive Sleep Aponea Hypopnea Syndrome (OSAHS)

Background and Objective:Obstructive sleep apnea hypopnea syndrome(OSAHS) is a common sleep related breathing disorder and repeated apnea disease, it can lead to all systemic complications, especially the cardiovascular system. In the present study, we use the INTERHEART Risk Score(IHRS) to assess prevalence and level of cardiovascular risk factors, It can provide early prevention and intervention strategy for cardiovascular disease in these OSAHS patients.Methods: Overnight polysomnography(PSG) was performed to a total of 219 patients in the sleep center of The Second Hospital Affiliated to Suzhou University from June 2015 to April 2016,including 183 males and 36 females. Based on the results of the aponea-hypopnea index(AHI) assessment,these patients were divided into four groups: primary snoring group, mild, moderate and severe OSAHS groups. INTERHEART Risk Score were caluculated according to cardiovascular risk factors: age&sex, diabetes, hypertension, family history, smoking, second hand smoke, psychosocial factors, dietary factors,physical activity, abdominal obesity, based on IHRS, 219 patients were divided into three groups :low risk group, moderate risk group and high risk group for a heart attack in the future. The differences and correlation analysis between the clinical parameters and PSG data of the groups were evaluated.Results:(1) The severe OSAHS group had significantly higher IHRS, waist hip ratio(WHR), body mass index(BMI), neck circumference than primary snoring group group: [(15.11± 6.50) vs(10.54± 4.31),(0.950 ±0.058)vs(0.899±0.088),(27.90 ±3.23) Kg/m2 vs(24.86 ± 3.35) Kg/m2,(40.47 ± 2.51) cm vs(37.06 ± 2.93) cm, all P < 0.05),OSAHS severity had positive correlation with the IHRS parameters in smoking(r = 0.259, P < 0.001), diabetes(r=0.176,P=0.009), and WHR(r=0.210,P=0.002).(2) The subjects with high IHRS were found with higher AHI, oxygen desaturation index(ODI), the Longest apnea time and the time of oxygen saturation< 90%(TS90%) than the low IHRS group[43.75(27.55~70.05)vs25.15(4.65~59.08), 42.15(20.23~64.98)vs22.05(4.43~47.10),(63.54 ± 22.46)s vs( 28.10 ± 18.22)s, 11.40(2.28~35.73)vs2.90(0.30~11.00),respectively, all P<0.05], and the lowest oxygen saturation(LSa O2), mean oxygen saturation(MSa O2) were decreased in high IHRS group than the low group, [75.00(65.50~85.00)vs82.50(73.50~88.00), 93.00(91.30~95.00) vs94.70(93.00~96.00),respectively, all P<0.05]. There were positive correlation between IHRS and AHI(r=0.245, P < 0.001), ODI(r=0.255, P < 0.001), T90%(r=0.254, P < 0.001), and negative correlation between IHRS and MSa O2(r=-0.218, P=0.001), LSa O2(r=-0.225, P=0.001), total sleep time(TST)(r=-0.149, P=0.027).Conclusions: Cardiovascular damage in patients with OSAHS is correlated with recurrent nocturnal apnea and hypoxia. Severe OSAHS patients had higher IHRS, Nocturnal oxygen reduction, smoking, diabetes, and WHR are important factors to predict this kind of cardiovascular disease.