Increased Cardiovascular Issues, Sleep Apnea Seen in Hospitalized Patients

Yedida Y Bogachkov PhD avatar

by Yedida Y Bogachkov PhD |

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Hospitalized patients with primary Sjögren’s syndrome (pSS) show an increased rate of specific cardiovascular concerns and sleep apnea syndrome (SAS), according to a study of a nationwide health insurance database in France.

The cardiovascular issues include ischemic heart disease (heart disease associated with narrowed blood vessels) and pulmonary hypertension (high blood pressure in the vessels leading to the lungs). Sleep apnea refers to episodes of breathing disruption during sleep.

The study, “Cardiovascular Events, Sleep Apnoea, and Pulmonary Hypertension in Primary Sjögren’s Syndrome: Data from the French Health Insurance Database,” was published in the Journal of Clinical Medicine.

The purpose of the study, which looked at new-onset patients hospitalized between 2011 and 2018, was to determine whether those with pSS are at higher risk of hospitalization for cardiovascular events (CVEs), venous thromboembolic events, pulmonary hypertension (PH), and SAS.

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Researchers suggested that regular screening for these co-existing conditions may improve the quality of life for pSS patients and reduce hospitalization rates.

“Our results [emphasize] the need for the early detection and management of cardiovascular risk factors and CVEs [cardiovascular events] in pSS to balance their major impact on hospitalization rate, disability outcomes, and quality of life,” the researchers wrote.

pSS is an autoimmune disease that affects the glands that produce tears and saliva, leading to dry eyes and mouth, pain, and fatigue.

Recent studies have shown that pSS patients may be at higher risk of cardiovascular issues that affect their mortality rates. Part of this increased risk may be due to accelerated atherosclerosis (thickening/hardening of arteries) and related to overall systemic inflammation and other cardiovascular risk factors, such as increased high blood pressure (hypertension) and increased lipids (fats) within the blood.

Current research yields mixed results as to the actual prevalence of cardiovascular events in pSS populations, however.

Thus, “this study aimed to describe the comparative incidence of major CVEs (IHDs [ischemic heart disease], stroke, and heart failure) and PH [pulmonary hypertension] in a real-life population of French hospitalized primary Sjögren’s syndrome (pSS) patients in comparison to age- and sex-matched controls,” the researchers wrote.

The cohort was 87.7% female with a mean age of 60. The median follow-up time was 3.96 years.

pSS patients had a higher proportion of past medical history of hypertension, diabetes, obesity, sleep apnea syndrome, cardiovascular disease, chronic kidney disease, and dialysis in previous hospitalizations, according to the data.

Chronic obstructive pulmonary disease (COPD), interstitial lung disease or fibrosis, and neuropsychiatric conditions were also seen more frequently among pSS patients.

Researchers found that pSS patients had an increased incidence of hospitalizations for sleep apnea syndrome, ischemic heart disease, and pulmonary hypertension compared to the controls. There was no increased incidence of stroke, heart failure, or aortic and peripheral artery diseases between the two groups, however.

No differences were found in the rates of venous thromboembolic events (clots within the veins) or pulmonary embolism (clots in the lungs) between pSS patients and controls.

Researchers found the incidence of death during hospitalization was not different between pSS patients and the control group among those affected by ischemic heart disease or pulmonary hypertension. There also was no difference in mortality rates among patients with stroke or heart failure.

The “large nationwide database study”  revealed a significantly increased incidence of IHD, SAS, and PH in hospitalized patients with pSS, the researchers concluded.

“Further prospective studies are needed to confirm these results and to explain the underlying [disease] mechanisms,” they added.

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