Medicine that may reduce heart disease

New York : Cholesterol-lowering drugs called statins have the potential to reduce heart disease in people with obstructive sleep apnoea, according to a new study.

Sleep apnoea is known to triple the risk of having a heart attack, stroke, or another serious cardiovascular event.

The study by Columbia University researchers suggests that statins can help regardless of the currently used CPAP (continuous positive airway pressure) machines to improve sleep quality and reduce daytime fatigue in people with obstructive sleep apnoea.

However, recent clinical trials showed that CPAP does not improve heart health as physicians originally hoped.

In the study, published in the journal Annals of the American Thoracic Society, the team included 87 people with recently diagnosed obstructive sleep apnoea who were being treated with CPAP. The patients were randomised to receive treatment with either statins or a placebo.

The researchers found that statins, but not CPAP, protected blood vessels against dangerous inflammatory changes that occur in people with the condition.

They looked specifically at the CD59 protein, which keeps inflammation in check when stabilised in the blood vessels.

The CD59 was stabilised after four weeks of cholesterol-lowering statin therapy, but not with CPAP alone.

“The effect we found with statins is important,” said Sanja Jelic, Associate Professor of medicine.

“Inflammation in the blood vessels is a key step in progression of cardiovascular disease, so anything that we can do to stabilise CD59 in these patients is likely to be beneficial for heart health,” Jelic added.

The researchers also found that CPAP, surprisingly, increases levels of angiopoietin-2, another protein associated with inflammation and heart disease, while statins lower it.

“We still believe CPAP is very useful, since it improves sleep and reduces daytime fatigue,” Jelic said.

“But CPAP also seems to have negative effects on the cardiovascular system. We need to investigate whether we should use more conservative airway pressures or other less-utilised treatments like oral appliances to treat patients with obstructive sleep apnoea.”

However, before physicians consider using statins to prevent heart disease in their sleep apnoea patients, clinical trials are needed to confirm that patients using statins will have fewer heart attacks and strokes in the long term, Jelic noted.