Sleep Apnea is Associated With Accelerated Vascular Aging: Results From 2 European Community-Based Cohort Studies

Quentin Lisan*, Thomas van Sloten, Pierre Boutouyrie, Stephane Laurent, Nicolas Danchin, Frederique Thomas, Catherine Guibout, Marie-Cecile Perier, Pieter Dagnelie, Ronald M. Henry, Miranda T. Schram, Raphael Heinzer, Pedro Marques-Vidal, Carla J. van der Kallen, Harry J. Crijns, Marleen van Greevenbroek, Koen Reesink, Sebastian Köhler, Manuel Sastry, Xavier JouvenCoen D. A. Stehouwer, Jean-Philippe Empana

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background The mechanisms underlying the association between obstructive sleep apnea (OSA) and cardiovascular disease may include accelerated vascular aging. The aim was to compare the magnitude of vascular aging in patients with high versus low risk of OSA. Methods and Results In 2 community-based studies, the PPS3 (Paris Prospective Study 3) and the Maastricht Study, high risk of OSA was determined with the Berlin questionnaire (a screening questionnaire for OSA). We assessed carotid artery properties (carotid intima-media thickness, Young's elastic modulus, carotid-femoral pulse wave velocity, carotid pulse wave velocity, carotid diameter using high precision ultrasound echography), and carotid-femoral pulse wave velocity (in the Maastricht Study only). Regression coefficients were estimated on pooled data using multivariate linear regression. A total of 8615 participants without prior cardiovascular disease were included (6840 from PPS3, 62% men, mean age 59.5 +/- 6.2 years, and 1775 from the Maastricht Study, 51% men, 58.9 +/- 8.1 years). Overall, high risk of OSA prevalence was 16.8% (n=1150) in PPS3 and 23.8% (n=423) in the Maastricht Study. A high risk of OSA was associated with greater carotid intima-media thickness (beta=0.21; 0.17-0.26), Young's elastic modulus (beta=0.21; 0.17-0.25), carotid-femoral pulse wave velocity (beta=0.24; 0.14-0.34), carotid pulse wave velocity (beta=0.31; 0.26-0.35), and carotid diameter (beta=0.43; 0.38-0.48), after adjustment for age, sex, total cholesterol, smoking, education level, diabetes mellitus, heart rate, and study site. Consistent associations were observed after additional adjustments for mean blood pressure, body mass index, or antihypertensive medications. Conclusions These data lend support for accelerated vascular aging in individuals with high risk of OSA. This may, at least in part, underlie the association between OSA and cardiovascular disease.

Original languageEnglish
Article number021318
Number of pages22
JournalJournal of the American Heart Association
Issue number15
Publication statusPublished - 3 Aug 2021


  • community-based study
  • sleep apnea
  • vascular aging
  • RISK

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