TY - JOUR
T1 - Healthy lifestyle factors and recurrent cardiovascular events in patients with OSA
T2 - the SAVE study
AU - You, Shoujiang
AU - Zheng, Danni
AU - Loffler, Kelly A.
AU - McEvoy, R. Doug
AU - Li, Qiang
AU - Luo, Yuanming
AU - Barbé, Ferran
AU - Ou, Qiong
AU - Chen, Rui
AU - Liu, Chun Feng
AU - Cao, Yongjun
AU - Wang, Xia
AU - Lorenzi-Filho, Geraldo
AU - Tripathi, Manjari
AU - Anderson, Craig S.
AU - SAVE investigators
PY - 2025/7/28
Y1 - 2025/7/28
N2 - Background: The extent to which healthy lifestyle factors influence recurrent cardiovascular events in obstructive sleep apnea (OSA) patients is uncertain. To evaluate the association between adherence to baseline healthy lifestyle and the risk of recurrent cardiovascular events in OSA patients. Methods: Post hoc analyses of the Sleep Apnea Cardiovascular Endpoints (SAVE) study involving participants with moderate-to-severe OSA and established cardiovascular disease (CVD) who were randomized to continuous positive airway pressure (CPAP) plus usual care or usual care alone. We assigned a score ranging from 0 to 4 for each participant, based on the number of criteria met for the baseline health lifestyle factors of non-smoking, moderate-to-vigorous physical activity, ideal waist/hip ratio, and low-to-moderate alcohol consumption. Results: In total, 2659 OSA patients with established CVD were included. The adjusted hazard ratios for participants with ≥ 2 healthy lifestyle factors compared with none were 0.64 (95% confidence interval [CI] 0.50-0.84) for composite cardiovascular events, 0.46 (0.28-0.74) for stroke, 0.65 (0.45-0.96) for hospitalization for unstable angina, 0.35 (0.19-0.63) for all-cause mortality, and 0.36 (0.16-0.79) for CVD death during a mean follow-up of 3.7 years. Each increment in healthy lifestyle factor score was associated with reduced risk of composite and separate cardiovascular events. A trend was found showing greater CPAP treatment benefit in those with more baseline healthy lifestyle for myocardial infarction and all-cause mortality; however, it did not reach statistical significance. Conclusions: Greater adherence to an overall baseline healthy lifestyle is significantly associated with a lower risk of recurrent composite cardiovascular events in OSA patients with established CVD.
AB - Background: The extent to which healthy lifestyle factors influence recurrent cardiovascular events in obstructive sleep apnea (OSA) patients is uncertain. To evaluate the association between adherence to baseline healthy lifestyle and the risk of recurrent cardiovascular events in OSA patients. Methods: Post hoc analyses of the Sleep Apnea Cardiovascular Endpoints (SAVE) study involving participants with moderate-to-severe OSA and established cardiovascular disease (CVD) who were randomized to continuous positive airway pressure (CPAP) plus usual care or usual care alone. We assigned a score ranging from 0 to 4 for each participant, based on the number of criteria met for the baseline health lifestyle factors of non-smoking, moderate-to-vigorous physical activity, ideal waist/hip ratio, and low-to-moderate alcohol consumption. Results: In total, 2659 OSA patients with established CVD were included. The adjusted hazard ratios for participants with ≥ 2 healthy lifestyle factors compared with none were 0.64 (95% confidence interval [CI] 0.50-0.84) for composite cardiovascular events, 0.46 (0.28-0.74) for stroke, 0.65 (0.45-0.96) for hospitalization for unstable angina, 0.35 (0.19-0.63) for all-cause mortality, and 0.36 (0.16-0.79) for CVD death during a mean follow-up of 3.7 years. Each increment in healthy lifestyle factor score was associated with reduced risk of composite and separate cardiovascular events. A trend was found showing greater CPAP treatment benefit in those with more baseline healthy lifestyle for myocardial infarction and all-cause mortality; however, it did not reach statistical significance. Conclusions: Greater adherence to an overall baseline healthy lifestyle is significantly associated with a lower risk of recurrent composite cardiovascular events in OSA patients with established CVD.
KW - Healthy lifestyle factors
KW - Obstructive sleep apnea
KW - Predict
KW - Recurrent cardiovascular events
KW - SAVE
UR - http://www.scopus.com/inward/record.url?scp=105012484212&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1006501
UR - http://purl.org/au-research/grants/NHMRC/1060078
U2 - 10.1186/s12916-025-04279-5
DO - 10.1186/s12916-025-04279-5
M3 - Article
C2 - 40721783
AN - SCOPUS:105012484212
SN - 1741-7015
VL - 23
JO - BMC Medicine
JF - BMC Medicine
IS - 1
M1 - 442
ER -
