{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T05:13:14Z","timestamp":1790485994670,"version":"4.1.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2016,12,1]],"date-time":"2016-12-01T00:00:00Z","timestamp":1480550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The interrelationships between obstructive sleep apnea (OSA) and obesity are complex and bidirectional; however, current evidence regarding their combined effect on cardiovascular risk is limited and conflicting. Animal studies suggest that obesity may exacerbate the cardiovascular consequences of intermittent hypoxemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In this historical observational study, we investigated whether obesity increases the effect of nocturnal hypoxemia on the incidence of cardiovascular events in adults with suspected OSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All adults with suspected OSA who underwent diagnostic polysomnography at a large academic hospital between 1994 and 2010 were linked to provincial health administrative data to determine a composite cardiovascular outcome (hospitalization due to heart failure, myocardial infarction, stroke, or revascularization procedures). Using a competing-risk model and controlling for confounders, hazards were compared between four groups: group 1 comprised obese patients (body mass index &amp;gt;30 kg\/m2) with oxygen desaturation (&amp;gt;9 min of sleep spent with SaO2 &amp;lt;90%); group 2 comprised obese patients without desaturation; group 3 comprised nonobese patients with desaturation; and group 4 comprised nonobese patients without desaturation. Interaction was measured using the relative excess risk due to interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>A total of 10,149 participants were followed, with 17%, 25%, 8%, and 50% in groups 1\u20134, respectively. Over a median of 7.8 years, 896 (8.8%) first cardiovascular events occurred. Group 1 was associated with the highest hazard compared with the other groups, using group 4 as a reference (hazard ratio [HR] for group 1, 1.84; 95% confidence interval [CI], 1.46\u20132.32; HR for group 2, 1.59, 95% CI, 1.29\u20131.95; HR for group 3, 1.51; 95% CI, 1.15\u20131.98). The relative excess risk due to interaction was \u22120.25 (95% CI, \u22120.78 to 0.27), indicating no interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In adults with suspected OSA, the highest cardiovascular risk was found in obese patients with nocturnal oxygen desaturation; however, the effect of these two factors together does not exceed the effect of each factor considered individually.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201604-263oc","type":"journal-article","created":{"date-parts":[[2016,9,30]],"date-time":"2016-09-30T16:10:31Z","timestamp":1475251831000},"page":"2234-2241","source":"Crossref","is-referenced-by-count":23,"title":["The Interaction of Obesity and Nocturnal Hypoxemia on Cardiovascular Consequences in Adults with Suspected Obstructive Sleep Apnea. 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