Körfer Daniel, Cardenas Wendy, Davis Lisa, Patel Shachi, Kosiborod Mikhail N, Magwire Melissa, Aistrope Daniel, Fialkow Jonathan, IIuyomade Adedapo, Walia Harneet K
Miami Cardiac and Vascular Institute, Baptist Health South Florida, 8900N Kendall Dr, Miami, FL 33176, USA.
Saint Luke's Mid America Heart Institute, 4401 Wornall Rd, Kansas City, MO 64111, USA.
Am J Prev Cardiol. 2025 Jul 22;23:101062. doi: 10.1016/j.ajpc.2025.101062. eCollection 2025 Sep.
To investigate the association of positive airway pressure (PAP) therapy and cardiometabolic factors in patients with sleep apnea (SA).
Patients with cardiometabolic disease from a multicenter cardiometabolic registry from January 2019 to August 2023 were included. Baseline characteristics of patients with SA stratified by PAP use were compared. Logistic regression was used to assess the association of PAP use and cardiometabolic factors (Hemoglobin A1c [HbA1c], systolic and diastolic blood pressure [SBP and SDB], Triglycerides [TG] and body mass index [BMI]) in an unadjusted model (Model 1), after adjusting for age, sex, ethnicity, race, BMI (Model 2), and additionally for cardiac comorbidities, medications, and medication adherence (Model 3).
Of a total of 1575 patients (median age: 65 years [interquartile range 58.0-71.0], 683 (43.4 %) presented with SA, and of those, 447 (65.4 %) reported routine PAP use. Logistic regression analysis showed that PAP use was associated with lower HbA1c (-0.31 %, 95 % CI -0.59 to -0.04, = 0.025) in Model 2, but not in Model 3 (-0.19 %, 95 % CI -0.46 to 0.08, = 0.165). In addition, PAP use was associated with lower SBP (-3.99 mmHg, 95 % CI -7.18 to -0.8, = 0.014) and lower DBP (-2.52 mmHg, 95 % CI -4.45 to -0.6, = 0.010) in Model 3.
In this multicenter registry of patients with cardiometabolic disease, PAP use was associated with improvement of cardiometabolic key risk factors. This effect was observed for SBP and DBP even after adjusting for medication adherence.
探讨睡眠呼吸暂停（SA）患者中持续气道正压通气（PAP）治疗与心脏代谢因素之间的关联。
纳入2019年1月至2023年8月来自多中心心脏代谢登记处的心脏代谢疾病患者。比较按PAP使用情况分层的SA患者的基线特征。在未调整模型（模型1）、调整年龄、性别、种族、民族、BMI后（模型2）以及另外调整心脏合并症、药物和药物依从性后（模型3），使用逻辑回归评估PAP使用与心脏代谢因素（糖化血红蛋白[HbA1c]、收缩压和舒张压[SBP和DBP]、甘油三酯[TG]和体重指数[BMI]）之间的关联。
总共1575例患者（中位年龄：65岁[四分位间距58.0 - 71.0]），其中683例（43.4%）患有SA，其中447例（65.4%）报告常规使用PAP。逻辑回归分析显示，在模型2中，PAP使用与较低的HbA1c相关（-0.31%，95%置信区间-0.59至-0.04，P = 0.025），但在模型3中不相关（-0.19%，95%置信区间-0.46至0.08，P = 0.165）。此外，在模型3中，PAP使用与较低的SBP（-3.99 mmHg，95%置信区间-7.18至-0.8，P = 0.014）和较低的DBP（-2.52 mmHg，95%置信区间-4.45至-0.6，P = 0.010）相关。
在这个多中心心脏代谢疾病患者登记处中，PAP使用与心脏代谢关键危险因素的改善相关。即使在调整药物依从性后，SBP和DBP也观察到了这种效果。
