[pp.03.17] association between sleep-disordered breathing and cardiovascular risk

Objective: To evaluate the association between obstructive sleep apnea (OSA) risk assessed by Berlin questionnaire and risk of fatal cardiovascular diseases estimated by SCORE. Design and method: We examined 275 subjects (115 males and 160 females, age 25–64 years old) without known cardiovascular diseases within the epidemiological study ESSE-RF. All participants underwent a structured interview. The risk of sleep-disordered breathing (SDB) was assessed by Berlin questionnaire, and cardiovascular risk was evaluated by SCORE scale (high risk chart). Anthropometry, blood pressure (BP), fasting glucose, lipids, uric acid, creatinine, C-reactive protein, adiponectin and leptin were assessed. Results: Based on Berlin questionnaire, 11.4% of subjects had high risk of OSA. The combination of snore/witnessed sleep apneas and cardiometabolic disorders was the most common (90.0%) manifestation. Complaints of snore/witnessed sleep apneas were more frequently reported by men (21.7% vs. 6.3%, p = 0.001), resulting in a higher OSA risk among males compared to females (11.3% vs. 4.4%, p = 0.03). Daytime sleepiness was the least complaint reported by both males and females (1.7% vs. 3.1%). High risk of OSA was more common in people older than 40 years old compared to the younger ones (9.8% vs. 1.2%, p = 0.01). Subjects with high OSA risk demonstrated more elevated total cholesterol (6.10 ± 0.18 vs. 5.53 ± 0.09 mmol/l, p = 0.05) and low-density lipoprotein level (4.17 ± 0.19 vs. 3.59 ± 0.08 mmol/l, p = 0.02); more severe obesity (body mass index 31.73 ± 1.19 vs. 27.71 ± 0.38 kg/m2, p = 0.001), and had higher rate of central obesity (68.4% vs. 34.5%, p = 0.006). They also showed elevated systolic (134.89 ± 4.96 vs. 126.72 ± 1.18 mmHg, p = 0.04) and diastolic BP (84.26 ± 2.69 vs. 78.55 ± 0.80 mmHg, p = 0.03). There was no association between SCORE cardiovascular risk and high risk of OSA independently of age and sex. Different combinations of OSA manifestations grouped by cluster analysis showed no impact of snore/sleep apneas or daytime sleepiness on cardiovascular risk. Conclusions: In Russian population, high risk of OSA is associated with the high prevalence of cardiometabolic disorders. Berlin questionnaire is an inappropriate tool for identifying people with co-existent high risk of OSA and high cardiovascular risk.