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Obstructive sleep apnea significantly increases the risk of stroke

September 16, 2017

The researchers found the increased risk to be independent of other factors, including hypertension. Participants were over age 50 without a history of heart attack or stroke at the start of the study. They were followed for an average of just under 3.5 years. The report cites support from the National Heart, Lung, and Blood Institute (NHLBI), the Yale Center for Sleep Medicine, and the Veterans Affairs Health Services Research and Development Service.

"Obstructive Sleep Apnea as a Risk Factor for Stroke and Death," and an accompanying editorial, "Sleep ?? A New Cardiovascular Frontier," by NHLBI grantee Virend K. Somers, M.D., Ph.D., will be published in the November 10 issue of the New England Journal of Medicine.

Carl E. Hunt, M.D., director of the NHLBI's National Center on Sleep Disorders Research, is available to comment on the study's findings and to discuss the signs and symptoms of obstructive sleep apnea, and the importance of diagnosing and treating the sleep-related breathing disorder. Untreated obstructive sleep apnea has been shown to increase the chance of cardiovascular disease and associated risk factors ?? including high blood pressure, heart attack, stroke, and diabetes -- as well as injuries or deaths from work-related accidents and vehicular crashes. NHLBI is currently supporting several large studies which follow participants over longer periods of time to confirm the longitudinal relationship between sleep apnea and stroke and associated risk factors.

nhlbi.nih/

4.24 for more than 200 mg/day of celecoxib 5.03 for more than 25 mg/day of rofecoxib 3.76 for more than 100 mg/day of diclofenac 1.22 for other NSAIDs (other non-specified NSAIDs were not divided into high or low dosages because it was a very heterogeneous group) 1.96 for more than 1200 mg/day of ibuprofen

Lower doses of celecoxib (hazard ratio 1.70) and rofecoxib (2.23) were also associated with a significantly higher risk of death, which was not found with lower doses of ibuprofen (hazard ratio 0.66) or diclofenac (0.74).

"The most important thing to recognize is that higher doses give a higher risk of death," Gislason said.

However, researchers did not find an increased risk of a second heart attack with any of the drugs or dosages. "This really surprised us because we had expected that the risk of recurrent heart attack would be high in this population," Gislason said.

The research team is analyzing death certificates to see what (if any) causes of death were more common in patients taking the drugs. "We're looking at both cardiovascular and non-cardiovascular causes of death," Gislason stated.

Gislason recommends that patients with cardiovascular disease who are taking COX-2 inhibitors or other NSAIDs should talk to their doctors.

americanheart/

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