Chest
Original Research: Sleep MedicineLow Socioeconomic Status Is a Risk Factor for Cardiovascular Disease Among Adult Obstructive Sleep Apnea Syndrome Patients Requiring Treatment
Section snippets
Study Design and Population
This study began in June 2003 in two universities with affiliated sleep-wake disorders centers. Prospective data were collected on consecutively recruited OSAS patients aged ≥ 18 years requiring treatment who underwent polysomnography and a healthy control group during the 13-month study period.
To reconfirm morbidity among OSAS patients, we compared 686 patients with OSAS to healthy subjects matched 1:1 by age, gender, geographic location, and family physician (p = 0.999). The control group was
RESULTS
A total of 1,214 subjects underwent polysomnography during the 13-month study period. Of those, 116 patients (9.6%) refused to participate in the study and 79 patients (6.5%) did not meet the inclusion criteria. Therefore, 1,019 patients were eligible for the study. Following polysomnography, 333 patients (32.7%) did not meet the inclusion criteria of OSAS severity. Finally, the study population included 686 OSAS patients requiring treatment. Of those, 364 patients (53.1%) had an AHI ≥ 30 (99,
DISCUSSION
The main novel finding of our study is that in addition to the already known traditional risk factors (age, gender, BMI, hypertension, and hyperlipidemia), low SES is an independent risk factor for CVD among OSAS patients requiring treatment.
REFERENCES (50)
- et al.
What are obstructive sleep apnea patients being treated for prior to this diagnosis?
Chest
(2002) - et al.
Determinants affecting health care utilization in OSAS patients
Chest
(2005) - et al.
Sleep apnea related intermittent hypoxia and atherogenesis: adhesion molecules and monocytes/endothelial cells interactions
Atherosclerosis
(2005) - et al.
Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome
Chest
(2005) - et al.
Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study
Lancet
(2005) - et al.
Risk factors, atherosclerosis, and cardiovascular disease among aboriginal people in Canada: the Study of Health Assessment and Risk Evaluation in Aboriginal Peoples (SHARE-AP)
Lancet
(2001) - et al.
Indications for positive airway pressure treatment of adult obstructive sleep apnea patients: a consensus statement
Chest
(1999) - et al.
Ethnic differences in the nutrient intake adequacy of premenopausal US women: results from the Third National Health Examination Survey
J Am Diet Assoc
(2003) - et al.
Self-reported health as a cultural health determinant in Arab and Jewish Israelis MABAT–National Health and Nutrition Survey 1999–2001
Soc Sci Med
(2005) - et al.
The Jewish-Arab divide in life expectancy in Israel
Econ Hum Biol
(2005)
Intermountain Heart Collaborative Study Group. Less affluent area of residence and lesser-insured status predict an increased risk of death or myocardial infarction after angiographic diagnosis of coronary disease
Ann Epidemiol
Socio-economic status and binge drinking in Israel
Drug Alcohol Depend
Coronary heart disease mortality among Arab and Jewish residents of Jerusalem
Lancet
Long-term follow-up of untreated patients with sleep apnoea syndrome
Respir Med
Epidemiology of obstructive sleep apnea: a population health perspective
Am J Respir Crit Care Med
Health care utilization in the 10 years prior to diagnosis in obstructive sleep apnea syndrome patients
Sleep
Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea
Circulation
Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study
Am J Respir Crit Care Med
Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study
BMJ
Social class, susceptibility and sickness
Am J Epidemiol
Primary care utilization in Israel: analysis of national data
Isr J Med Sci
Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction?
Am J Epidemiol
Does low socioeconomic status potentiate the effects of heightened cardiovascular responses to stress on the progression of carotid atherosclerosis?
Am J Public Health
Relation between socioeconomic deprivation and death from a first myocardial infarction in Scotland: population based analysis
BMJ
Relationship of socioeconomic status to the incidence and prehospital, 28-day, and 1-year mortality rates of acute coronary events in the FINMONICA Myocardial Infarction Register Study
Circulation
Cited by (55)
Effective feature selection based on Fisher Ratio for snoring recognition using different validation methods
2022, Applied AcousticsCitation Excerpt :Snoring is one of the important and typical symptoms of OSAHS, which is caused by the vibration of the soft palate, the uvula, and posterior pharyngeal pillars [10]. The detection of snoring signal is a preliminary, but indispensable work during the whole process of acoustic analysis of OSAHS [11–13]. The problem of snoring recognition from recorded sounds has been widely investigated.
Association between socioeconomic status, belonging to an ethnic minority and obstructive sleep apnea: a systematic review of the literature
2019, Sleep MedicineCitation Excerpt :Links with SES and sleep disturbance have been observed for household income and educational attainment [14,15]. Low SES was also found to be a risk factor for cardiovascular disease among OSA patients requiring treatment [16]. Racial disparities exist regarding general health.
Low BMI is inversely associated with arterial stiffness in Africans
2015, British Journal of NutritionPrevalence of overlap syndrome in patients with obstructive sleep apnea in a quaternary care center of Kerala
2022, Indian Journal of Public HealthSocioeconomic status impacts blood pressure response to positive airway pressure treatment
2022, Journal of Clinical Sleep MedicineCosts of Treatment Non-adherence in Obstructive Sleep Apnoea
2022, CPAP Adherence: Factors and Perspectives
Institute for Health Policy and Health Services Research, award No. B/17/2000.
The authors declare that they have no financial conflict of interest with any manufacturers or products mentioned in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).