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(Hypertension. 2006;47:e1.)
© 2006 American Heart Association, Inc.

Hypertension Electronic Pages

Obstructive Sleep Apnea in Overweight Subjects

Department of Cardiology, Complejo Hospitalario de Jaén, Jaén, Spain

Alberto Alonso-Fernández; Francisco García-Río

Department of Neumology, Hospital Universitario La Paz, Madrid, Spain

An extract of the first 100% of the full text is provided, because this article has no abstract.

To the Editor:

In the excellent study by Thomas et al,¹ a significant increased cardiovascular mortality rate was reported in obese individuals when that condition was associated with the presence of hypertension with or without other cardiovascular risk factors, such as hyperlipidemia or diabetes mellitus. As a result, the authors conclude that overweight should be considered as a major cardiovascular risk determinant. We would like to highlight the common association between obesity and obstructive sleep apnea (OSA), and why it is conceivable nowadays that OSA could be responsible, in part, for the cardiovascular mortality reported in obese subjects. Obesity is the main risk factor for developing OSA, and 40%² to 90%³ of obese individuals are affected by OSA. Marin et al⁴ have recently reported a significantly higher incidence of fatal and nonfatal cardiovascular events in patients with untreated severe OSA as compared with untreated subjects with mild-moderate OSA, individuals correctly treated for OSA, and normal healthy subjects. Importantly, the increased risk of fatal and nonfatal cardiovascular events achieved in the group of untreated severe OSA patients was independent of other confounding factors such as body mass index or hypertension. Indeed, the association between OSA and systemic hypertension has also been well established.⁵ In view of the aforementioned data, it is our opinion that the possible presence of undiagnosed OSA should be investigated in every obese patient as another valuable measure to prevent the development of fatal and nonfatal cardiovascular events.

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2. Vgontzas AN, Tan TL, Bixler EO, Martin LF, Shubert D, Kales A. Sleep apnea and sleep disruption in obese patients. Arch Intern Med. 1994; 154: 1705–1711.[Abstract/Free Full Text]

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5. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42: 1206–1252.[Abstract/Free Full Text]