The prevalence of arterial hypertension (HT), diabetes, obesity, active smoking, hyperlipidemia and family history of coronary heart disease was 54.1%, 22.8%, 65.8%, 18.3%, 33.8% and 20%, respectively. Women had significantly more HT (62.1 vs 51.4%), diabetes (29.9 vs 20.4%), obesity (77 vs 62%) and family history of coronary disease (25.1 vs 18.2%). The prevalence of active smoking was significantly higher in men (20.4 vs 12%). The prevalence of hyperlipidemia was not different between men and women (34.5 vs 31.8%). Stepwise logistic regression showed that HT and diabetes were both independently associated with BMI and age, while diabetes and not HT was independently associated with female gender. The prevalence of classical CV risk factors was very high in this population with OSAS requiring CPAP, especially in women. There is thus a very elevated CV risk level independent of that directly related to OSAS. It is important to screen for and treat classical CV risk factors in this population.

Background: The aetiologies of chronic respiratory failure (CRF) are moving in many western countries. Obesity-Hypoventilation syndrome (OHS) has become one of the most common indications of non-invasive ventilation (NIV) with Chronic Obstructive Pulmonary Diseases (COPD). Long-Term Oxygen Therapy (LTOT) technology is the treatment plan for CRF patients in the new era. Objectives: This study aimed to assess home-based care evolution in CRF patients on LTOT (LTOT) and/or NIV from the ANTADIR observatory. Methods: A computerized database from 14 regional facilities was analysed (30% of French home-treated patients). Patient age, sex, aetiology, home respiratory devices were recorded between 2001 and 2015. Results: By the end of 2015, 12,147 CRF patients received LTOT (40%), NIV (24%), LTOT + NIV (23%), continuous positive airway pressure (CPAP; 11%) or LTOT + CPAP (3%). Between 2001 and 2015, we observed a decrease of LTOT (63–40%) in the benefit of NVI ± LTOT (25–47%). Regarding the aetiology, we note a slight decrease in obstructive disease and a significant increase in restrictive disease, mainly due to OHS. The 10-year survival was better on NIV ± LTOT than on LTOT, for overall patients and for both obstructive and restrictive patients. The 10-year survival was better on NIV ± LTOT than on LTOT (35 vs. 10%, p < 0.05). In COPD patients on LTOT, a switch from conventional to new home devices was observed. Stationary LTOT systems were less prescribed, while portable/transportable ­system, liquid oxygen and self-filling oxygen were increasingly prescribed. Conclusion: Our study confirmed changes in CRF aetiologies and home devices. OHS is now an important indication of NIV. Using new LTOT technologies changed home prescriptions in COPD patients.

In 159 chronic obstructive pulmonary disease (COPD) patients (139 males, mean age 62 +/- 8 yrs, arterial oxygen tension (PaO2) 7.2 +/- 0.9 kPa), on long-term oxygen therapy (LTOT), we evaluated the effects of portable oxygen therapy both on the daily duration of oxygen therapy and on daily activities. They were given two types of LTOT at random: group A (n = 75), oxygen concentrators only (OC); group B (n = 84), either small oxygen cylinders plus OC (B1 = 51) or liquid oxygen (B2 = 33). The patients were followed-up for one year by means of: a) medical examination every three months; b) monthly home interviews concerning the daily duration of oxygen therapy, the utilization of the devices and the daily activities of the patients; c) a measurement of the daily oxygen usage. The results show that: 1) there are no significant clinical and functional differences between groups A and B at the onset of and throughout the study; 2) in group B the daily use of oxygen therapy is significantly longer than in group A (17 +/- 3.5 h.day-1 vs 14 +/- 3 h.day-1, p less than 0.01) without any difference between groups B1 and B2; 3) outdoor walking activities are different between groups A and B, at least in those patients using oxygen more than 18 h.day-1. Only 60% of patients in group B (55% of B1; 67% of B2) use their portable devices outdoors and for walking. No strict predictive criterion of this use is found in our study.(ABSTRACT TRUNCATED AT 250 WORDS)

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