CPAP Use in Elderly Patients With OSA Appears to Reduce The Risk of Cardiovascular Death

ATS 2011, DENVER – According to a landmark study by researchers in Spain, continuous positive airway pressure (CPAP) effectively decreases the risk of cardiovascular death in elderly patients who suffer from obstructive sleep apnea (OSA). The findings presented at the American Thoracic Society's 2011 International Conference, held from May 13th to 18th in Denver, are the first large-scale study to assess the impact of OSA and the effectiveness of CPAP treatment in cardiovascular mortality in the elderly.

Miguel Angel Martinez-Garcia, M.D., of the Hospital General de Requena in Valencia, Spain, and colleagues evaluated 939 elderly patients referred with suspected OSA between 1999 and 2007. They followed the patients through 2009. The investigators divided patients into four groups, including a control group without OSA, mild to moderate OSA patients without CPAP treatment, patients with severe OSA without CPAP treatment, and patients with any degree of OSA who underwent CPAP treatment.

“Our study offers two key conclusions,” said Miguel Angel Martinez-Garcia, MD, study lead author pneumonologist at the Hospital General de Requena in Valencia, Spain. “First, with younger patients, elderly patients with severe, untreated sleep apnea have a higher cardiovascular mortality than those with mild to moderate disease or those without sleep apnea; and second, treatment with CPAP can reduce cardiovascular mortality in elderly OSA patients to levels similar to those found in patients without disease or with mild to moderate sleep apnea.”

The investigators found that untreated severe OSA was independently associated with all-cause and cardiovascular mortality, and also with heart failure and stroke mortality, but not with ischemic heart disease mortality. The investigators also found that CPAP treatment reduced increased risks of mortality among OSA patients.

“CPAP has been shown to be a very effective treatment for severe and symptomatic forms of sleep apnea,” he said. “However, virtually all studies on the effectiveness of CPAP to date have been conducted in middle-aged individuals, despite the fact that a growing percentage of the patients we see in our sleep units are elderly and are treated with CPAP. “This is a very important issue considering the gradual increase in longevity worldwide,” he added.

Millions of people worldwide suffer from sleep apnea, which has been associated with cardiovascular health risks and poorer quality of life. Most studies, however, have been conducted in younger populations, Dr. Martínez-García noted.

Dr. Martínez-García said the results were not entirely unexpected, since anecdotal evidence and several smaller studies have indicated CPAP offers improved outcomes in certain patients, notably patients at risk for stroke. In CPAP, pressurized air is delivered continuously through a mask worn over the nose or nose and mouth to help keep the soft tissues of the airway from collapsing.

"Our study provides an excellent scientific basis for further studies in this area given a lack of scientific evidence on the impact of sleep apnea and the role of CPAP treatment in elderly patients," Martinez-Garcia said in a statement. "These findings clearly support the fact that treatment with CPAP is effective in elderly people and therefore, within logical limits, it must be a treatment that is offered to patients with severe or symptomatic OSA regardless of their age.

“The next step is to assess the effect of CPAP treatment in elderly OSA patients in large, randomized clinical trials,” he added. “These studies should explore not only cardiovascular outcomes, but other outcomes such as neurocognitive dysfunction.”

Sources:
“All-Cause And Cardiovascular Mortality In Elderly Patients With Sleep Apnea. Role Of CPAP Treatment. A 6-Year Follow-Up Study” (Session A19, Sunday, May 15, 8:15-10:45 a.m., Room 201-203 (Street Level), Colorado Convention Center; Abstract 20052)

* Please note that numbers in this release may differ slightly from those in the abstract. Many of these investigations are ongoing; the release represents the most up-to-date data available at press time.

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This release was published on openPR.