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Letters |5 June 2012

Cardiovascular Mortality in Women With Obstructive Sleep Apnea With or Without Continuous Positive Airway Pressure Treatment

Thomas E. Finucane, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From Johns Hopkins University School of Medicine, Baltimore, MD 21224.

    Potential Conflicts of Interest: None disclosed.

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TO THE EDITOR:
In 1980, the Coronary Drug Project (1) showed that among patients assigned to placebo, those who faithfully (at least 80% of the time) took the lactose placebo had a roughly 50% reduction in death compared with those who took the pill less faithfully. The authors note “the serious difficulty, if not impossibility, of evaluating treatment efficacy in subgroups determined by patient ... adherence ....” Adherent patients seem different from nonadherent patients in ways that are difficult to characterize.
Campos-Rodriguez and colleagues (2) compared cardiovascular mortality rates in women “with OSA [obstructive sleep apnea] [who] were classified as CPAP [continuous positive airway pressure]–treated (adherence ≥4 hours per day) or untreated (adherence <4 hours per day or not prescribed).” The authors conclude that “CPAP treatment is associated with a decrease in mortality risk.” They do not indicate how many patients in the “untreated group” had not been prescribed CPAP, and how many had been prescribed it and did not use it (2).
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Finucane TE. Cardiovascular Mortality in Women With Obstructive Sleep Apnea With or Without Continuous Positive Airway Pressure Treatment. Ann Intern Med. ;156:838. doi: 10.7326/0003-4819-156-11-201206050-00012

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Published: Ann Intern Med. 2012;156(11):838.

DOI: 10.7326/0003-4819-156-11-201206050-00012

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