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Sleep apnea, diabetes, cardiac rehab and cardiovascular risk

Posted Jan 25 2010 12:00am
Published January 25th, 2010 in , , , , , , ,

Obstructive sleep apnea and cardiovascular risk

If you’re a loud snorer who doesn’t feel rested enough during the day, you may be unwittingly putting your heart at risk. That’s because you could have untreated Obstructive Sleep Apnea (OSA), a disorder directly linked to several cardiovascular syndromes that cause premature death. OSA, in which the upper airway becomes blocked repeatedly during sleep, is a condition that affects 24 percent of men and 8 percent of women.

Over the past 10 years, several studies have linked OSA to high blood pressure. Patients who require three or more medications to control hypertension have an 80 percent chance of having OSA. Also, compared to the general population the prevalence of OSA is significantly higher among patients with chronic heart failure (50 percent higher), a trial fibrillation (50 percent higher) and coronary artery disease (40 percent higher). For patients with these heart conditions, a sleep study is crucial; if their OSA goes undiagnosed and untreated, they will have a doubled risk for death during the next 5 years.

Given OSA’s direct connection to the heart, it’s important for all patients that it be treated as soon as possible. However, it’s estimated that between 80 percent and 90 percent of people with OSA have not yet been diagnosed. Individuals who have one or more of these symptoms should talk with their doctors about a sleep study:

• Cessation of breathing during sleep, and then waking up with a gasp (most often observed by another)
• Loud, irregular snoring
• Restless sleep with frequent (and possibly unnoticed) awakening
• Morning headache, dry mouth and/or sore throat
• Daytime sleepiness
• Irritability and/or impaired concentration
• High blood pressure

The link between diabetes and heart disease

Living with diabetes can be challenging by itself. However, if people with type 2 diabetes don’t manage their conditions, they could develop heart disease.

In fact, the numbers are frightening. Heart disease and strokes are the number one killers of people with type 2 diabetes. Both are responsible for the about 65 percent of the deaths of people with diabetes. That’s why it’s so important to understand the connection and to learn to use prevention methods.

Diabetes happens when there is a breakdown in the way our bodies turn food into fat and energy. Most of the food we ingest is turned into glucose, also called blood sugar. Glucose is the primary fuel for our bodies. However, over time, if our blood glucose is too high, it can harm our blood vessels and nerves. That’s because both are an important part of our cardiovascular systems.

However, the news is not doom and gloom. Each person has the power to control many factors associated with both diabetes and heart disease through education and determination.

It’s no surprise that eating healthy is a major factor in delaying or preventing these two health challenges. However, just as important is setting nutritional goals that each person is able to reach and then keep. It’s not question of going on a diet or cutting out certain foods if that will end in failure. The changes need to be a lifestyle change. The key is to work with a dietician and other heart and diabetes experts to put together a personal plan that gives each individual the best chance of succeeding.

It’s also not shocking that exercise is another crucial component in the fight against both heart disease and diabetes. Again, what’s significant here is creating a routine that can be followed. Choosing an effective workout that keeps a person motivated is necessary to make sure a person incorporates it into daily life. There are as many ways to become, and stay, active as there are hobbies that people enjoy.

Taking prescribed medication, not smoking and support from family members can also make all of the difference for people with heart disease and diabetes.

Cardiac rehab lowers death risk

For people who have had a heart attack or certain other heart condition, participating in an outpatient cardiac rehabilitation program can be key to ensuring that they don’t have another heart event.

A new study published in the 5/12 January 2010 issue of Circulation demonstrates that the more sessions of cardiac rehabilitation a heart patient participated in, the more his or her risk for heart attack and sudden death was reduced. For example, people who attended 36 sessions of cardiac rehab had over the next four years:

• an 18 percent lower risk of death compared to those who attended 24 sessions
• a 29 percent lower risk of death than those who attended just 12 sessions, and
• a 58 percent lower risk of death than those who attended only 1 session.

Cardiac rehab gives patients a customized exercise plan and lifestyle modification coaching to help get their hearts into shape. Unfortunately, only 18 percent of cardiac rehab patients complete all 36 sessions, the number reimbursed by Medicare (Newswise).

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