CORONARY HEART-DISEASE AND UPPER AIRWAY-OBSTRUCTION

Coronary heart disease (CHD) is a leading cause of death among middle- aged men. In the same age group the spectrum of upper airway obstructi on from habitual snoring to obstructive sleep apnoea syndrome (OSAS) i s frequent. In several studies snoring was found to be an important ri sk factor for ischaemic heart disease, The prevalence of OSAS in patie nts with CHD, profile of risk factors and ventricular arrhythmias was determined in a prospective manner in 78 patients with stenosis of one or more coronary arteries at coronary arterography, OSAS was found in 27 patients (34.6%), Mean respiratory disturbance index (RDI) was 23. 9. RDI increased with higher age. No significant differences in both g roups could be found in ventricular arrhythmias, left ventricular ejec tion fraction and risk factors, except hyperuricaemia and adiposity. O SAS is frequent in patients with CHD and may be an additional risk fac tor besides the known coronary risk factors. Patients with the combina tion of CHD and OSAS have to be regarded as a group at particular risk because of several interactions between OSAS and coronary haemodynami cs. Furthermore the microstructure of sleep in patients with nocturnal myocardial ischaemia is disturbed.