Patients with Obstructive Sleep Apnea Display Increased Carotid Intima Media: A Meta-Analysis
Open Access
- 27 August 2013
- journal article
- review article
- Published by Hindawi Limited in International Journal of Vascular Medicine
- Vol. 2013, 1-8
- https://doi.org/10.1155/2013/839582
Abstract
Background. Obstructive sleep apnea (OSA) is associated with coronary artery disease. Intermittent hypoxia associated with OSA increases sympathetic activity and may cause systemic inflammation, which may contribute to atherosclerosis leading to an increase in the size of carotid intima media thickness (CIMT).Methods. PubMed and Cochrane library were reviewed by utilizing different combinations of key words: sleep apnea, carotid disease, intima media thickness, and carotid atherosclerosis. Inclusion criteria were English articles; studies with adult population with OSA and without OSA; CIMT recorded by ultrasound in mean and standard deviation or median with 95% confidence interval; and OSA defined as apnea hypopnea index of ≥5/h. A total of 95 studies were reviewed for inclusion, with 16 studies being pooled for analysis.Results. Ninety-five studies were reviewed, while 16 studies were pooled for analysis; since some studies have more than one data set, there were 25 data sets with 1415 patients being pooled for meta-analysis. All studies used ultrasound to measure CIMT. CIMT standardized difference in means ranged from −0.883 to 8.01. The pooled standardized difference in means was 1.40 (lower limit 0.996 to upper limit 1.803, ().Conclusion. Patients with OSA appear to have increased CIMT suggestive of an atherosclerotic process.
Keywords
This publication has 33 references indexed in Scilit:
- The incremental role of obstructive sleep apnoea on markers of atherosclerosis in patients with metabolic syndromeAtherosclerosis, 2010
- Association of urinary 15-F2t-isoprostane level with oxygen desaturation and carotid intima–media thickness in nonobese sleep apnea patientsFree Radical Biology & Medicine, 2010
- Correlation Between Carotid Intimal/Medial Thickness and AtherosclerosisArteriosclerosis, Thrombosis, and Vascular Biology, 2010
- Increased Circulating Endothelial Microparticles and Carotid Atherosclerosis in Obstructive Sleep ApneaJournal of Clinical Neurology, 2010
- Impact of Obstructive Sleep Apnoea on Clinical Characteristics and Outcomes in Patients with Acute Coronary Syndrome following Percutaneous Coronary InterventionJournal of International Medical Research, 2009
- Clinical and Research Applications of Carotid Intima-Media ThicknessThe American Journal of Cardiology, 2009
- Additive Effects of Obstructive Sleep Apnea and Hypertension on Early Markers of Carotid AtherosclerosisHypertension, 2009
- Ultrasound imaging techniques for the evaluation of cardiovascular therapiesEuropean Heart Journal, 2008
- Aortic Stiffness, Flow-Mediated Dilatation and Carotid Intima-Media Thickness in Obstructive Sleep ApneaRespiration, 2006
- Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators.Stroke, 1993