Association between left ventricular end-diastolic volume and cardiovascular disease in systemic hypertensive patients with obstructive sleep apnea

BACKGROUND AND PURPOSE: Systemic hypertension and obstructive sleep apnea (OSA) are closely linked conditions that substantially increase the risk of cardiovascular disease (CVD). Left ventricular end-diastolic volume (LVEDV) is a crucial echocardiographic marker of cardiac remodeling; however, its prognostic value in patients with concomitant systemic hypertension and OSA remains poorly defined. This study aimed to examine the association between LVEDV and the incidence of CVD in this high-risk population. METHODS: This retrospective cohort study included patients with confirmed systemic hypertension and OSA, who were stratified into tertiles based on baseline LVEDV. Multivariable Cox proportional hazards models, adjusted for demographic factors, comorbid conditions, and OSA severity, were used to evaluate CVD risk. Sensitivity and stratified analyses were conducted to assess the robustness of the findings. RESULTS: A total of 1914 patients (mean age 48.7 ± 10.2 years) were followed for a median of 83 months, during which 186 incident CVD events were documented. The incidence of CVD increased progressively across LVEDV tertiles. In fully adjusted analyses, patients in the highest tertile (T3: >81 mL) showed a significantly higher risk of CVD compared with those in the lowest tertile (T1: