Cardiovascular disease risk assessment in patients with obstructive sleep apnoea: clinical utility of the Framingham risk equation for initiating statins

Horwood, F; Gruber, Andreas; Sithole, Jabulani; Ali, Nabeel; Idris, Iskandar

doi:10.1111/j.1463-1326.2007.00732.x

Cited by 5 publications

(3 citation statements)

References 9 publications

(8 reference statements)

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“…Thus, a combination of statin treatment with CPAP therapy could be useful to better control blood pressure in OSA patients and to reduce associated cardiovascular morbidity and mortality. Indeed, in view of the high risk of cardiovascular disease (CVD) in patients with OSA, the use of statins in this group of patients, irrespective of their baseline cholesterol levels, should be encouraged [ 46 ]. While absolute risk assessment is essential when considering primary prevention for CVD, an uncritical application of the Framingham risk equation may result in the underuse of statins in patients with OSA.…”

Section: Discussionmentioning

confidence: 99%

“…While absolute risk assessment is essential when considering primary prevention for CVD, an uncritical application of the Framingham risk equation may result in the underuse of statins in patients with OSA. Thus, when the Framingham risk tool is used to manage statin treatment for primary CVD prevention in OSA patients, a lower CVD risk threshold than that recommended by current guidelines may need to be set [ 46 ]. Evidence from large registries and long-term prospective trials is now required to determine the potential synergic beneficial effects and the rate of new cardiovascular events in patients with OSA receiving combined statin and CPAP therapy.…”

Section: Discussionmentioning

confidence: 99%

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Response to Statin Therapy in Obstructive Sleep Apnea Syndrome: A Multicenter Randomized Controlled Trial

Joyeux‐Faure

Tamisier

Baguet

et al. 2014

Mediators of Inflammation

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Rationale. Accumulated evidence implicates sympathetic activation as inducing oxidative stress and systemic inflammation, which in turn lead to hypertension, endothelial dysfunction, and atherosclerosis in obstructive sleep apnea (OSA). Statins through their pleiotropic properties may modify inflammation, lipid profile, and cardiovascular outcomes in OSA. Methods. This multicenter, randomized, double-blind study compared the effects of atorvastatin 40 mg/day versus placebo over 12 weeks on endothelial function (the primary endpoint) measured by peripheral arterial tone (PAT). Secondary endpoints included office blood pressure (BP), early carotid atherosclerosis, arterial stiffness measured by pulse wave velocity (PWV), and metabolic parameters. Results. 51 severe OSA patients were randomized. Key demographics for the study population were age 54 ± 11 years, 21.6% female, and BMI 28.5 ± 4.5 kg/m2. In intention to treat analysis, mean PAT difference between atorvastatin and placebo groups was 0.008 (−0.29; 0.28), P = 0.979. Total and LDL cholesterol significantly improved with atorvastatin. Systolic BP significantly decreased with atorvastatin (mean difference: −6.34 mmHg (−12.68; −0.01), P = 0.050) whereas carotid atherosclerosis and PWV were unchanged compared to the placebo group. Conclusion. In OSA patients, 3 months of atorvastatin neither improved endothelial function nor reduced early signs of atherosclerosis although it lowered blood pressure and improved lipid profile. This trial is registered with NCT00669695.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Response to Statin Therapy in Obstructive Sleep Apnea Syndrome: A Multicenter Randomized Controlled Trial

Joyeux‐Faure

Tamisier

Baguet

et al. 2014

Mediators of Inflammation

View full text Add to dashboard Cite

show abstract

“…64 Another presentation discussed the finding that continuous positive airway pressure does not improve glycaemic control in patients with insulin resistance or type 2 diabetes and OSA. 65 OXYGEN AND VENTILATION Support for the new home oxygen guidelines introduced in February 2006 was reinforced in a poster indicating that patients' oxygen requirements change within 6 weeks of discharge from hospital, hence the importance of follow-up assessment at this time.…”

Section: Sleep Disordered Breathing and Obstructive Sleep Apnoeamentioning

confidence: 99%

The birth and re-birth of respiratory medicine notes from the British Thoracic Society Winter Meeting 2006

Quint

Baghai-Ravary²

2007

Thorax

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Innate immune mechanisms linking non-esterified fatty acids and respiratory disease

Wood

Scott

Garg

et al. 2009

Progress in Lipid Research

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Cardiovascular disease risk assessment in patients with obstructive sleep apnoea: clinical utility of the Framingham risk equation for initiating statins

Cited by 5 publications

References 9 publications

Response to Statin Therapy in Obstructive Sleep Apnea Syndrome: A Multicenter Randomized Controlled Trial

Response to Statin Therapy in Obstructive Sleep Apnea Syndrome: A Multicenter Randomized Controlled Trial

The birth and re-birth of respiratory medicine notes from the British Thoracic Society Winter Meeting 2006

Innate immune mechanisms linking non-esterified fatty acids and respiratory disease

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