{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:43:56Z","timestamp":1792197836041,"version":"4.4.0"},"reference-count":43,"publisher":"BMJ","issue":"12","funder":[{"DOI":"10.13039\/501100012166","name":"National Basic Research Program of China","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,10,11]]},"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to conduct a meta-analysis to explore and summarise the evidence regarding the association between obstructive sleep apnoea (OSA) and the subsequent risk of vascular outcomes and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic databases PubMed, Embase and the Cochrane Library were searched to identify studies conducted through May 2016. Prospective cohort studies that reported effect estimates with 95% CIs of major adverse cardiac events (MACEs), coronary heart disease (CHD), stroke, cardiac death, all-cause mortality and heart failure for different levels versus the lowest level of OSA were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 16 cohort studies reporting data on 24\u2009308 individuals were included. Of these, 11 studies reported healthy participants, and the remaining five studies reported participants with different diseases. Severe OSA was associated with an increased risk of MACEs (relative risk (RR): 2.04; 95%\u2009CI 1.56 to 2.66; P&lt;0.001), CHD (RR: 1.63; 95%\u2009CI 1.18 to 2.26; P=0.003), stroke (RR: 2.15; 95%\u2009CI 1.42 to 3.24; P&lt;0.001), cardiac death (RR: 2.96; 95%\u2009CI 1.45 to 6.01; P=0.003) and all-cause mortality (RR: 1.54; 95%\u2009CI 1.21 to 1.97; P&lt;0.001). Moderate OSA was also significantly associated with increased risk of MACEs (RR: 1.16; 95%\u2009CI 1.01 to 1.33; P=0.034) and CHD (RR: 1.38; 95%\u2009CI 1.04 to 1.83; P=0.026). No significant association was found between mild OSA and the risk of vascular outcomes or all-cause mortality (P&gt;0.05). Finally, no evidence of a factor-specific difference in the risk ratio for MACEs among participants with different levels of OSA compared with those with the lowest level of OSA was found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Severe and moderate OSAs were associated with an increased risk of vascular outcomes and all-cause mortality. This relationship might differ between genders. Therefore, further large-scale prospective studies are needed to verify this difference.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013983","type":"journal-article","created":{"date-parts":[[2017,12,23]],"date-time":"2017-12-23T00:21:58Z","timestamp":1513988518000},"page":"e013983","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":168,"title":["Association of obstructive sleep apnoea with the risk of vascular outcomes and all-cause mortality: a meta-analysis"],"prefix":"10.1136","volume":"7","author":[{"given":"Chengjuan","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruolin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanghua","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Anhui Province, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Anhui Province, Hefei, China"},{"name":"Department of Medical Psychology, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,12,22]]},"reference":[{"key":"2025121509554742000_7.12.e013983.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199304293281704"},{"key":"2025121509554742000_7.12.e013983.2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00587.2005"},{"key":"2025121509554742000_7.12.e013983.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/IJG.0000000000000357","article-title":"Meta-analysis of association of obstructive sleep apnea with glaucoma","volume":"25","author":"Liu","year":"2016","journal-title":"J Glaucoma"},{"key":"2025121509554742000_7.12.e013983.4","doi-asserted-by":"crossref","first-page":"301","DOI":"10.5665\/sleep.5432","article-title":"The association between obstructive sleep apnea on diabetic kidney disease: a systematic review and meta-analysis","volume":"39","author":"Leong","year":"2016","journal-title":"Sleep"},{"key":"2025121509554742000_7.12.e013983.5","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-015-0102-3"},{"key":"2025121509554742000_7.12.e013983.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0146317","article-title":"Can continuous positive airway pressure reduce the risk of stroke in obstructive sleep apnea patients? a systematic review and meta-analysis","volume":"11","author":"Kim","year":"2016","journal-title":"PLoS One"},{"key":"2025121509554742000_7.12.e013983.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.16303"},{"key":"2025121509554742000_7.12.e013983.8","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.5664\/jcsm.4282","article-title":"Effect of CPAP treatment for obstructive sleep apnea hypopnea syndrome on lipid profile: a meta-regression analysis","volume":"10","author":"Nadeem","year":"2014","journal-title":"J Clin Sleep Med"},{"key":"2025121509554742000_7.12.e013983.9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"2025121509554742000_7.12.e013983.10","unstructured":"Wells G , Shea B , O\u2019Connell D . 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