Daily Dose: Sleep Apnea May Raise Risk of Certain Cardiovascular Diseases

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On January 30, 2023, we reported on a study published in the European Journal of Preventive Cardiology that assessed the existence and direction of the causal relationship between sleep apnea (SA) or snoring and cardiovascular diseases (CVDs).

The study

Researchers conducted a bidirectional, 2-sample Mendelian randomization study that included 523 366 participants, of whom 25 008 had a single nucleotide polymorphism associated with SA and 172 050 had a single nucleotide polymorphism associated with snoring. Multivariable Mendelian randomization was used to assess the direct effect of SA on CVD after adjusting for body mass index (BMI).

After the research team corrected for multiple testing, the inverse-variance weighted average showed that SA and snoring increased the risk of hypertension (HTN) (odds ratio [OR] 1.03, 95% CI 1.02-1.05; OR 1.05, 95% CI 1.03-1.07) and CAD (OR 1.41, 95% CI 1.19-1.67; OR 1.61, 95% CI 1.26-2.07), with a false-discovery rate (FDR) <.05. Snoring and SA were not associated with atrial fibrillation, heart failure, or stroke. HTN was associated with an increased risk of SA (OR 1.53, 95% CI 1.04-2.25), but this association did not pass multiple comparisons (FDR >.05).

Note from authors

"Our results suggest that SA and snoring increased the risk of hypertension and CAD, and these associations may partly be driven by BMI. Conversely, no evidence of CVDs causally influencing SA or snoring was found."

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