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阻塞性睡眠呼吸暂停患者中估计脉搏波速度与全因死亡率和心血管死亡率的关联：来自美国国家健康与营养检查调查（NHANES）的结果

Association of estimated pulse wave velocity with all-cause mortality and cardiovascular mortality in obstructive sleep apnea patients: results from NHANES.

作者信息

Lin Huizhong, Zheng Huiyun, Lin Tao, Chen Lianglong

机构信息

Department of Cardiology, Fujian Medical Center for Cardiovascular Diseases, Fujian Institute of Coronary Heart Disease, Fujian Medical University Union Hospital, Fuzhou, China.

Department of Epidemiology, School of Public Health, Fujian Medical University, Fuzhou, China.

出版信息

Front Cardiovasc Med. 2025 Jun 12;12:1571610. doi: 10.3389/fcvm.2025.1571610. eCollection 2025.

DOI:10.3389/fcvm.2025.1571610
PMID:40574813
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12198205/
Abstract

BACKGROUND: This study aims to investigate the relationship between estimated pulse wave velocity (ePWV) and all-cause mortality (ACM) and cardiovascular mortality (CVM) in patients with obstructive sleep apnea (OSA). METHOD AND RESULTS: A cohort study was conducted using data from the NHANES database (2005-2008, 2015-2018), focusing on adults with OSA. ePWV was calculated based on age and mean blood pressure. A weighted Cox regression model analyzed the association of ePWV with ACM and CVM, while restricted cubic spline (RCS) curves visualized this relationship. Kaplan-Meier (KM) survival curves assessed survival across different ePWV groups.The study involved 10,071 OSA patients with an average age of 48.46 years, with a follow-up period ending in December 2019 (average follow-up time: 102.10 ± 2.34 months). Results showed that increased ePWV correlated with higher ACM [hazard ratio [HR]: 1.25, 95% confidence interval [CI]: 1.20-1.31] and CVM (HR: 1.28, 95% CI: 1.21-1.36). RCS curves indicated stable mortality risks at ePWV ≤ 8.1 m/s, with rapid increases beyond this threshold. KM curves demonstrated poorer survival outcomes for OSA patients with elevated ePWV. CONCLUSION: Elevated ePWV levels are linked to increased ACM and CVM in OSA patients, suggesting that monitoring ePWV could help mitigate these risks and promote healthier longevity in this population.

摘要

背景：本研究旨在探讨阻塞性睡眠呼吸暂停（OSA）患者的估计脉搏波速度（ePWV）与全因死亡率（ACM）和心血管死亡率（CVM）之间的关系。 方法与结果：利用美国国家健康与营养检查调查（NHANES）数据库（2005 - 2008年，2015 - 2018年）的数据进行了一项队列研究，重点关注成年OSA患者。基于年龄和平均血压计算ePWV。采用加权Cox回归模型分析ePWV与ACM和CVM的关联，同时用受限立方样条（RCS）曲线直观展示这种关系。采用Kaplan - Meier（KM）生存曲线评估不同ePWV组的生存情况。该研究纳入了10,071例OSA患者，平均年龄48.46岁，随访期至2019年12月结束（平均随访时间：102.10 ± 2.34个月）。结果显示，ePWV升高与更高的ACM相关[风险比[HR]：1.25，95%置信区间[CI]：1.20 - 1.31]和CVM（HR：1.28，95% CI：1.21 - 1.36）。RCS曲线表明，ePWV≤8.1 m/s时死亡风险稳定，超过此阈值后迅速增加。KM曲线显示，ePWV升高的OSA患者生存结局较差。 结论：ePWV水平升高与OSA患者的ACM和CVM增加有关，这表明监测ePWV有助于降低这些风险，并促进该人群更健康长寿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34dc/12198205/e2d0587f6155/fcvm-12-1571610-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34dc/12198205/0e26177aedbd/fcvm-12-1571610-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34dc/12198205/54ba180fb4c0/fcvm-12-1571610-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34dc/12198205/bffad6f25170/fcvm-12-1571610-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34dc/12198205/e2d0587f6155/fcvm-12-1571610-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34dc/12198205/0e26177aedbd/fcvm-12-1571610-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34dc/12198205/54ba180fb4c0/fcvm-12-1571610-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34dc/12198205/bffad6f25170/fcvm-12-1571610-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34dc/12198205/e2d0587f6155/fcvm-12-1571610-g004.jpg

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本文引用的文献

[1]
Charting the Unseen: How Non-Invasive Imaging Could Redefine Cardiovascular Prevention.

J Cardiovasc Dev Dis. 2024-8-9

[2]
Sleep Apnea and Heart Failure-Current State-of-The-Art.

Int J Mol Sci. 2024-5-11

[3]
Predicting heart failure symptoms from the apnoea-hypopnoea index determined by full- night polysomnography.

ESC Heart Fail. 2024-10

[4]
A Systematic Review of Risk factors for Sleep Apnea.

Prev Med Rep. 2024-5-3

[5]
Influence of Blood Pressure Reduction on Pulse Wave Velocity in Primary Hypertension: A Meta-Analysis and Comparison With an Acute Modulation of Transmural Pressure.

Hypertension. 2024-7

[6]
Correlation between obstructive sleep apnea and hypoperfusion in patients with acute cerebral infarction.

Front Neurol. 2024-4-8

[7]
Estimated pulse wave velocity and risk of new-onset heart failure.

ESC Heart Fail. 2024-8

[8]
Arterial stiffness is associated with handgrip strength in relatively healthy Chinese older adults.

Front Nutr. 2024-2-9

[9]
Evaluation of Arterial Stiffness in Depression Patients.

Alpha Psychiatry. 2023-9-1

[10]
Objective Sleep Duration and All-Cause Mortality Among People With Obstructive Sleep Apnea.

JAMA Netw Open. 2023-12-1

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