DefinePK

Abstract

Background: Obstructive sleep apnea (OSA) is increasingly acknowledged as an independent risk factor for cardiovascular disease (CVD), mainly due to intermittent hypoxia, systemic inflammation, and sympathetic overactivity. Despite its clinical significance, there is a scarcity of longitudinal data from South Asia, particularly Pakistan, assessing CVD progression about OSA severity. Objective: To investigate the relationship between the severity and progression of obstructive sleep apnea (OSA) and cardiovascular disease. Study Design: Prospective longitudinal study. Setting: This study was conducted at a tertiary care hospital in Pakistan. Duration of Study: April 2023 to October 2023, (enrollment), with a 12-month follow-up period for each participant. Methods: A total of 78 adults with newly diagnosed moderate to severe obstructive sleep apnea (Apnea-Hypopnea Index [AHI] ≥15), confirmed through polysomnography, were enrolled. Participants were followed for 12 months, during which cardiovascular parameters—including systolic and diastolic blood pressure, lipid profile, high-sensitivity C-reactive protein (hs-CRP), and cardiovascular events (such as myocardial infarction and angina)—were monitored. Data were analyzed using SPSS version 26. Statistical tests included paired t-tests, chi-square tests, and logistic regression; p-values less than 0.05 were considered statistically significant. Results: Over the 12-month follow-up, there were statistically significant increases in: Systolic blood pressure (mean +6.7 mmHg, p = 0.01), Diastolic blood pressure (mean +4.2 mmHg, p = 0.03), LDL cholesterol levels (p = 0.04), hs-CRP levels (p < 0.01), Cardiovascular events occurred more frequently in the severe OSA group (8 events) than in the moderate OSA group (3 events). Severe OSA and elevated hs-CRP levels (≥5 mg/L) were identified as independent predictors of cardiovascular events with odds ratios (OR) of 3.8 and 4.1, respectively. Conclusion: Severe obstructive sleep apnea significantly contributes to cardiovascular disease progression in the Pakistani population, likely mediated through inflammatory and hypertensive mechanisms. Early detection and management of OSA may offer a strategic opportunity to mitigate long-term cardiovascular risks.