Adherence to CPAP Treatment Vital for Cardiovascular Health in Sleep Apnea Patients: JAMA

In a groundbreaking study, researchers have explored the impact of continuous positive airway pressure (CPAP) treatment on individuals suffering from obstructive sleep apnea (OSA) with cardiovascular disease. The results have sparked new hope for secondary cardiovascular disease prevention. They found that adherence to CPAP reduced the risk of recurrent major adverse cardiac and cerebrovascular events (MACCEs). 

The study results were published in the journal JAMA Network on October 3, 2023. 

The effect of CPAP treatment on secondary cardiovascular disease prevention has been a subject of intense debate among medical experts. OSA, a sleep disorder characterized by interrupted breathing during sleep, has long been associated with an increased risk of cardiovascular events. However, the extent to which CPAP treatment can mitigate this risk has remained uncertain. To shed light on this issue, a team of researchers conducted an extensive meta-analysis to assess the impact of CPAP treatment on the risk of adverse cardiovascular events in individuals who suffer from both cardiovascular disease and OSA. 

The researchers systematically searched various databases, including PubMed, EMBASE, and ClinicalTrials.gov, to gather relevant data till June 22, 2023. The team evaluated a total of 4,186 individual participants, predominantly men, with a mean age of 61.2 years and a mean body mass index of 28.9. The participants had a history of cardiovascular disease and OSA, making them ideal subjects for the study. The primary outcome of the study was the occurrence of major adverse cardiac and cerebrovascular events (MACCEs). 

Key findings: 

• Among 4186 individuals nearly half of the participants were receiving CPAP (50.1%) and the remaining were not receiving CPAP (49.9%). 
• The initial analysis might not have signaled a remarkable change and did not paint a different picture between those receiving CPAP and those not. 
• However, it was discovered that patients adhering well to CPAP (defined as using the device for at least four hours a day) experienced a substantial 31% reduction in the risk of MACCE recurrence. 

Thus, this discovery marks a paradigm shift in cardiovascular care strategies. It emphasizes the significance of not just prescribing CPAP but ensuring its consistent and proper use. This individualized approach could significantly alter the landscape of cardiovascular disease management, offering hope to countless individuals grappling with the dual burden of OSA and heart-related ailments. 

Further reading: Sánchez-de-la-Torre M, Gracia-Lavedan E, Benitez ID, et al. Adherence to CPAP Treatment and the Risk of Recurrent Cardiovascular Events: A Meta-Analysis. JAMA. 2023;330(13):1255–1265. doi:10.1001/jama.2023.17465