Higher age and BMI predict OSA in both sexes; smoking and hypertension predict OSA in men only, eGFR <60 in women; >50% with OSA had metabolic syndrome equally by sex.
What are the sex differences in clinical characteristics, cardiovascular disease prevalence, and risk factors among patients with obstructive sleep apnea?
There are distinct sex-specific predictors for obstructive sleep apnea, with smoking and hypertension predicting OSA in men, and reduced eGFR predicting OSA in women, though both sexes share a high burden of cardiometabolic risk factors.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background Obstructive sleep apnea (OSA) is more prevalent in men than women. Although the exact explanation for this is unknown, some recent studies have indicated that there are relevant sex differences in the pathophysiology, clinical presentation and symptoms of OSA. The aims of the present study were to explore sex differences in clinical characteristics, prevalence of cardiovascular disease (CVD), and associated risk factors in patients with OSA. Methods Between January 2016 and December 2018, 2401 patients with suspected OSA underwent standard respiratory polygraphy and completed extensive questionnaires including items on age, sex, sleepiness, smoking and prior history of CVD (myocardial infarction and/or stroke) and chronic obstructive pulmonary disease (COPD). Height, weight, body mass index (BMI) and blood pressure were measured. Patients also provided blood samples (analysed for estimated glomerular filtration rate, eGFR). OSA was defined as apnea-hypopnea index (AHI) ≥15/h regardless of symptoms, and also classified according to severity grade (AHI ≤5 as no OSA, AHI 5-14.9 as mild, AHI 15-29.9 as moderate and AHI ≥30 as severe OSA). Cardiometabolic risk factors were defined as obesity, diabetes, dyslipidemia, and/or hypertension. Results The prevalence of OSA was 36.2% (n=868). There were 77.4% (n=672) men and 22.6% (n=196) women in the OSA group. Women with OSA were older, had higher BMI and lower eGFR, while men were more likely to have higher blood pressure and prior history of myocardial infarction. The prevalences of overall CVD, atrial fibrillation, diabetes and COPD were comparable between women and men with OSA (all p0.05). A dose-dependent increase in the number of cardiometabolic risk factors according to the OSA severity grade was observed both in women and men (Figure 1A-B). Patients having none or 1 cardiometabolic risk factor tended to have either no OSA or mild OSA, while patients with 2 cardiometabolic risk factors were more likely to have mild to moderate OSA. Patients with 3 cardiometabolic risk factors had mainly moderate or severe OSA, equally represented between women and men (p=0.811). The independent predictors of OSA were higher age and BMI in both sexes, smoking, hypertension and excessive sleepiness in men, and eGFR 60 mL/min/m2 in women. Conclusions Higher age and BMI were identified as independent predictors of OSA in both sexes, whereas smoking and hypertension were predictors in men only, and eGFR 60 mL/min/m2 in women only. More than half of patients with OSA had features of metabolic syndrome, evenly distributed between men and women, highlighting the importance of strict control of cardiometabolic risk factors both in women and men with OSA.
Romarheim et al. (Sat,) reported a other. Higher age and BMI predict OSA in both sexes; smoking and hypertension predict OSA in men only, eGFR <60 in women; >50% with OSA had metabolic syndrome equally by sex.