{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:03:38Z","timestamp":1758945818272,"version":"3.37.3"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Guangzhou Science and Technology Planning Project","award":["202102080611"],"award-info":[{"award-number":["202102080611"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81870077"],"award-info":[{"award-number":["81870077"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Most patients with comorbid sleep apnea (OSA), cardiovascular (CV) disease, and\/or cerebrovascular (CeV) disease simultaneously take medications. Whether OSA and continuous positive airway pressure (CPAP) interact with CV\/CeV medications remains unknown. This study aimed to determine the interaction among OSA, CPAP, and CV\/CeV medications; the effects of medications on major adverse cardiac and cerebrovascular events, and survival in patients with comorbid OSA and CV\/CeV.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a post hoc analysis of the data from one center of the Sleep Apnea Cardiovascular Endpoints Study. Participants (aged 45\u201375\u2009years) with comorbid OSA and CV\/CeV were randomized to receive usual care with or without CPAP from December 2008 to November 2013. The primary endpoint was death and the secondary endpoint was a composite of death, myocardial infarction, stroke, hospitalization for unstable angina, heart failure, and transient ischemic attack.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 131 patients were analyzed. Sixty-three were in the CPAP group and 68 were in the usual care group, 41 had good adherence to CPAP (65.1%), and the median follow-up time was 43.0 (35.0, 54.0) months. In Cox regression analysis, ACE inhibitors and nitrates were independent factors for decreased survival in patients with comorbid OSA and CV\/CeV (chi-square\u2009=\u200922.932, <jats:italic>P<\/jats:italic>\u2009=\u20090.003; ACE inhibitors: OR 7.241, <jats:italic>P<\/jats:italic>\u2009=\u20090.048, 95% CI 1.016\u201351.628; nitrates: OR 18.012, <jats:italic>P<\/jats:italic>\u2009=\u20090.011, 95% CI 1.923\u2013168.750). ACE inhibitors increased mortality and secondary endpoints in the CPAP group (chi-square\u2009=\u20094.134, <jats:italic>P<\/jats:italic>\u2009=\u20090.042) but not in patients with good CPAP adherence. Clopidogrel and nitrates decreased survival in usual care group (clopidogrel: chi-square\u2009=\u20095.312, <jats:italic>P<\/jats:italic>\u2009=\u20090.021; nitrates: chi-square\u2009=\u20096.417, <jats:italic>P<\/jats:italic>\u2009=\u20090.011), but not in CPAP group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>OSA may predispose patients with CV\/CeV and CV\/CeV medications to a negative effect. CPAP treatment may neutralize the negative effects of OSA by relieving chronic intermittent hypoxia.<\/jats:p>\n                <jats:p><jats:italic>Trial registration<\/jats:italic> ClinicalTrials.gov (NCT00738179, first registration date: 20\/08\/2008).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12890-022-01879-2","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T14:35:54Z","timestamp":1647873354000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The interaction among OSA, CPAP, and medications in patients with comorbid OSA and cardiovascular\/cerebrovascular disease: a randomized controlled trial"],"prefix":"10.1186","volume":"22","clinical-trial-number":[{"clinical-trial-number":"nct00738179","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Miaochan","family":"Lao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yilu","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinglin","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiong","family":"Ou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"issue":"21","key":"1879_CR1","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1161\/CIRCULATIONAHA.115.019392","volume":"133","author":"CH Lee","year":"2016","unstructured":"Lee CH, Sethi R, Li R, Ho HH, Hein T, Jim MH, et al. 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