Statins Help Minimize Heart Disease in Sleep Apnea Patients

Statins help protect blood vessels from harmful inflammation, while CPAP therapy increased inflammation levels.

Highlights:

Statins may be an effective alternate strategy to reduce heart disease risk in sleep apnea patients, who are at a higher risk of cardiovascular events
CPAP therapy improves sleep quality but may have negative effects on the cardiovascular system by increasing inflammatory protein levels
Clinical trials are needed to prove that statins can reduce the risk of heart attacks and strokes in the long run before they can be widely prescribed to sleep apnea patients

Cholesterol-lowering medicines known as statins have the potential to minimize heart disease in persons with obstructive sleep apnea regardless of whether they use CPAP equipment at night.

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‘While CPAP therapy increases levels of a protein linked to inflammation and heart disease, statins protect blood vessels from harmful inflammatory changes. However, clinical trials are necessary to prove the long-term benefits of statins before they can be widely prescribed.’

Use of CPAP in Sleep Apnea

In persons with obstructive sleep apnea, CPAP (continuous positive airway pressure) therapy improves sleep quality and reduces daytime weariness. Yet, according to the findings of several recent clinical research, CPAP does not improve heart health as physicians had hoped.

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Sleep Apnea Increases Risk of Heart Disease

Alternate strategies to minimize heart disease in sleep apnea sufferers are desperately needed, as the illness has been shown to treble the risk of having a heart attack, stroke, or other catastrophic cardiovascular events.

According to a new study led by Sanja Jelic, M.D., associate professor of medicine at Columbia University Vagelos Faculty of Physicians and Surgeons, statins (a type of cholesterol-lowering medicine) may be one such technique.

The study comprised 87 participants who had just been diagnosed with obstructive sleep apnea and were using CPAP. The participants were randomly assigned to receive either statins or a placebo. The researchers discovered that statins, but not CPAP, protected blood vessels from the condition's harmful inflammatory alterations.

The researchers focused on the CD59 protein, which, when stabilized in blood vessels, controls inflammation. A previous study by Jelic's team found that when cholesterol levels are low, CD59, which shields cells from complement (a set of proteins that cause inflammation), is more stable. CD59 was stabilized in study participants following four weeks of cholesterol-lowering statin treatment, but not with CPAP alone.

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CPAP Raises Inflammatory Protein Levels

Surprisingly, the researchers discovered that CPAP raises levels of angiopoietin-2, another protein linked to inflammation and heart disease. Increased angiopoietin-2 levels are typical in patients on mechanical ventilation but have never been recorded in CPAP users. Statins were found to reduce angiopoietin-2 levels in patients with obstructive sleep apnea in the study.

"We still believe CPAP is very useful since it improves sleep and reduces daytime fatigue," Jelic says. "But CPAP also seems to have negative effects on the cardiovascular system. We need to investigate whether we should use more conservative airway pressures or other less-utilized treatments like oral appliances to treat patients with obstructive sleep apnea."

However, before physicians consider taking statins to prevent heart disease in their sleep apnea patients, clinical trials are required to prove that patients who use statins have fewer heart attacks and strokes in the long run, according to Jelic.

Statins are now prescribed to just 8% to 13% of people with obstructive sleep apnea.

Source-Medindia

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