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April 20, 2026European Heart Journal102 citationsOpen Access

Composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular mortality in older community-dwelling men

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Mathias Baumert
Mathias BaumertElectrophysiology
SISarah A. ImmanuelTorrens University AustraliaKSKatie L. StoneUniversity of California, San Francisco

Key Result

T90 (nocturnal hypoxaemic burden) is an independent predictor of cardiovascular mortality in older community-dwelling men, reflecting both frank desaturations and non-specific oxygen drifts.

Key Points

  • To examine the nocturnal hypoxaemic burden and its potential as a prognostic indicator for cardiovascular mortality in older men.
  • Analyzed overnight oximetry data from polysomnograms in 2840 older men from the MrOS Sleep study.
  • Calculated oxygen desaturation index (ODI) and time spent below 90% oxygen saturation (T90).
  • Performed follow-up over 8.8 years to assess cardiovascular mortality.
  • T90 was significantly associated with cardiovascular death (HR 1.21, P < 0.001) and remained significant after adjusting for confounders (HR 1.16, P = 0.004).
  • Men with T90 > 12 min had an increased risk of CV mortality (HR 1.59; P = 0.006).
  • Non-specific drifts accounted for approximately 20.7% of the variation in T90 but did not improve predictive value when combined with T90desaturation.

Study Design

Type

Cohort

Structured PICO

Does nocturnal hypoxaemic burden (T90) predict cardiovascular mortality in older community-dwelling men?

P
Population
older community-dwelling men
I
Intervention
T90 (nocturnal hypoxaemic burden)
O
Outcome
cardiovascular mortalityhard clinical

Nocturnal hypoxaemic burden (T90) is an independent predictor of cardiovascular mortality in older men, suggesting its potential utility as a clinical risk marker.

Abstract

AIMS: To investigate the composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular (CV) mortality in community-dwelling older men. METHODS AND RESULTS: We analysed overnight oximetry data from polysomnograms obtained in 2840 men from the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study (ClinicalTrials.gov Identifier: NCT00070681) to determine the number of acute episodic desaturations per hour (oxygen desaturation index, ODI) and time spent below 90% oxygen saturation (T90) attributed to acute desaturations (T90desaturation) and to non-specific drifts in oxygen saturation (T90non-specific), respectively, and their relationship with CV mortality. After 8.8 ± 2.7 years follow-up, 185 men (6.5%) died from CV disease. T90 [hazard ratio (HR) 1.21, P  12 min were at an elevated risk of CV mortality (HR 1.59; P = 0.006). Approximately 20.7 (5.7-48.5) percent of the variation in T90 could be attributed to non-specific drifts in oxygen saturation. T90desaturation and T90non-specific were individually associated with CV death but combining both variables did not improve the prediction. CONCLUSION: In community-dwelling older men, T90 is an independent predictor of CV mortality. T90 is not only a consequence of frank desaturations, but also reflects non-specific drifts in oxygen saturation, both contributing towards the association with CV death. Whether T90 can be used as a risk marker in the clinical setting and whether its reduction may constitute a treatment target warrants further study.

Expert Takes2 quotes

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“The study shows for the first time that poor blood oxygenation during sleep predicts the chance of heart-related death in elderly men. The study also demonstrates that reduced blood oxygenation cannot be attributed to episodic drops in oxygen alone.”

Dominik Linz, Associate Professor, University of Adelaide Medical Schoolauto_pipelineSupportiveView source
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Cite This Study

Baumert et al. (2018) conducted a cohort in Nocturnal hypoxaemic burden. T90 (nocturnal hypoxaemic burden) was evaluated on Cardiovascular mortality. T90 (nocturnal hypoxaemic burden) is an independent predictor of cardiovascular mortality in older community-dwelling men, reflecting both frank desaturations and non-specific oxygen drifts.

synapsesocial.com/papers/69e69847c715c26d55d593edhttps://doi.org/10.1093/eurheartj/ehy838
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