Association of obstructive sleep apnoea with subclinical coronary atherosclerosis

Atherosclerosis. 2013 Dec;231(2):191-7. doi: 10.1016/j.atherosclerosis.2013.09.011. Epub 2013 Sep 24.


Background: Accumulating evidence suggests a role of obstructive sleep apnoea (OSA) as a risk factor for coronary atherosclerosis. This study aimed i) to assess the prevalence of OSA in the general population and ii) to analyse the association of this disorder with traditional cardiovascular disease risk factors and subclinical coronary atherosclerosis.

Methods: In a cross-sectional analysis of the Heinz Nixdorf Recall study a subgroup of 1604 subjects (791 men, age 50-80 years) underwent OSA screening. Furthermore, coronary artery calcium (CAC) was measured. OSA was defined as apnoea-hypopnoea index (AHI) ≥ 15/h.

Results: OSA was observed in 29.1% of men and 15.6% of women. In a multiple linear regression analysis adjusted for risk factors AHI was associated with CAC in men aged ≤65 years (estimated log-transformed increase of CAC = 0.25, 95% confidence interval (CI) = -0.001-0.50, p = 0.051) and in women of any age (estimated log-transformed increase = 0.23, 95% CI = 0.04-0.41, p = 0.02). Doubling of the AHI was associated with a 19% increase of CAC in men aged ≤65 years and with a 17% increase in women of any age.

Conclusions: In the general population aged ≥50 years OSA is associated with subclinical atherosclerosis in men aged ≤65 years and in women of any age, independent of traditional cardiovascular risk factors.

Keywords: Coronary artery calcium; Heinz Nixdorf Recall study; Obstructive sleep apnoea; Sleep-disordered breathing; Subclinical atherosclerosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Atherosclerosis / complications*
  • Calcium / metabolism
  • Coronary Artery Disease / complications
  • Coronary Vessels / pathology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Prevalence
  • Regression Analysis
  • Risk Factors
  • Sex Factors
  • Sleep Apnea, Obstructive / complications*
  • Surveys and Questionnaires


  • Calcium