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Although novel hypoxic indices have been proposed to tackle these limitations, there remains a gap in comprehensive validation and comparisons across a unified dataset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Samples were derived from the Sleep Heart Health Study (SHHS), involving 4485 participants aged over 40\u2009years after data quality screening. The study compared several key indices, including AHI, ODI, the reconstructed hypoxic burden (rHB), the percentage of sleep time with the duration of respiratory events causing desaturation (pRED_3p) and the sleep breathing impairment index (SBII), in relation to CVD mortality and morbidity risks. Adjusted Cox proportional models were employed to calculate hazard ratios (HRs) for each index, and comparisons were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SBII and pRED_3p exhibited significant correlations with both CVD mortality and morbidity, with SBII showing the highest adjusted HR (95% confidence interval) for mortality (2.04 [1.25, 3.34]) and pRED_3p for morbidity (1.43 [1.09\u20101.88]). In contrast, rHB was only significant in predicting CVD mortality (1.63 [1.05\u20132.53]), while AHI and ODI did not show significant correlations with CVD outcomes. The adjusted models based on SBII and pRED_3p exhibited optimal performance in the CVD mortality and morbidity datasets, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study identified the optimal indices for OSA\u2010related CVD risks prediction, SBII for mortality and pRED_3p for morbidity. The open\u2010source online platform provides the computation of the indices.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.14754","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T06:49:12Z","timestamp":1716360552000},"page":"825-834","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Hypoxic indices for obstructive sleep apnoea severity and cardiovascular disease risk prediction: A comparison and application in a community population"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7048-9505","authenticated-orcid":false,"given":"Xinjie","family":"Hui","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhao","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; 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