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Correlates of Endothelial Function in Older Adults With Untreated Obstructive Sleep Apnea and Cardiovascular Disease

Imes, Christopher C., PhD; Baniak, Lynn M., PhD; Choi, JiYeon, PhD; Luyster, Faith S., PhD; Morris, Jonna L., BSN; Ren, Dianxu, MD, PhD; Chasens, Eileen R., PhD

doi: 10.1097/JCN.0000000000000536
Feature Article/Online Only
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Background: Obstructive sleep apnea (OSA) is a highly prevalent and consequential sleep disorder in older adults. Untreated moderate to severe OSA substantially increases the risk for hypertension and cardiovascular disease (CVD), which can be attributed to the accelerated progression of atherosclerosis and endothelial dysfunction.

Objective: The aim of this study was to identify factors that can function as correlates of endothelial function in older adults with untreated, moderate to severe OSA and CVD or CVD risk factors.

Methods: A subsample (N = 126) of adults aged 65 years and older from the HeartBEAT study were included in the analyses. Univariate analyses and multiple linear regression models were conducted to establish which demographic and CVD risk factors were the best correlates of endothelial function.

Results: In the univariate analyses, sex, employment status, body mass index, waist circumference, hip-to-waist ratio, neck circumference, diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, total cholesterol to high-density lipoprotein cholesterol ratio, plasminogen activator inhibitor-1, calcium channel blocker use, and β-blocker use were associated with endothelial function at a level of P < .10. In the most parsimonious model, male sex (b = −0.305, P < .001), calcium channel blocker use (b = −0.148, P < .019), and body mass index (b = −.014, P < .037) were negatively associated with endothelial function after adjusting for the other covariates.

Conclusions: The authors identified correlates of endothelial function in older adults with untreated OSA and CVD or CVD risk factors, which are different than the correlates in middle-aged adults with the same conditions.

Christopher C. Imes, PhD University of Pittsburgh School of Nursing, Pennsylvania.

Lynn M. Baniak, PhD University of Pittsburgh School of Nursing, Pennsylvania.

JiYeon Choi, PhD University of Pittsburgh School of Nursing, Pennsylvania; and Yonsei University College of Nursing, Seoul, Korea.

Faith S. Luyster, PhD University of Pittsburgh School of Nursing, Pennsylvania.

Jonna L. Morris, BSN University of Pittsburgh School of Nursing, Pennsylvania.

Dianxu Ren, MD, PhD University of Pittsburgh School of Nursing, Pennsylvania.

Eileen R. Chasens, PhD University of Pittsburgh School of Nursing, Pennsylvania.

Support for the study reported in this article was provided by grants from the National Heart, Lung, and Blood Institute (RC2 HL101417, 1R01HL109493, and R21HL108226); National Sleep Research Resource (R24 HL114473); and National Center for Research Resources (UL1 RR024989). Support for L.M.B was provided by the T32: Translational Sleep Medicine (HL82610) at the University of Pittsburgh School of Medicine.

The authors have no conflicts of interest to disclose.

Correspondence Christopher C. Imes, PhD, University of Pittsburgh School of Nursing, 336 Victoria Bldg, 3500 Victoria St, Pittsburgh, PA 15261 (imesc@pitt.edu).

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