Association of Obstructive Sleep Apnea with Incidence of Serious Cardiovascular Events in the Elderly: A Meta-analysis

SummaryBackgroundWe aimed to evaluate the association between obstructive sleep apnea (OSA) and the incidence of a series cardiovascular events in the elderly.MethodsWe systematically searched PubMed, Embase, Springer link, the Cochrane library, and two Chinese databases (Wanfang data and CNKI database) for relevant studies which were published before October 10, 2014 and recruited participants with a mean age of > 60 years. Risk ratios (RR) and 95% confidence intervals (CI) were used to evaluate the association between OSA and cardiovascular events or mortality risk. Sensitivity analysis was performed by omitting each study according to different criteria. In addition, Egger's test was used to assess the publication bias.ResultsA total of 11 studies with 22,046 participants were included in this meta-analysis. Our results showed that OSA could significantly increase the risk of cardiovascular disease [(CVD) RR = 2.04, 95% CI = 1.28-3.23], stroke (RR = 2.29, 95% CI = 1.49-3.51) and all-cause mortality (RR = 1.48, 95% CI = 1.13-1.94) for the elderly. However, no significant association was found between OSA and coronary heart disease [(CHD) RR = 1.43, 95% CI = 0.96-2.23]. Sensitivity analysis showed that the results were relatively stable. In addition, no publication bias was observed.ConclusionOSA can significantly increase the risk of CVD, stroke and all-cause mortality for the elderly. However, no significant association was observed between OSA and CHD.