Περίληψη:
Introduction: There is growing research evidence suggesting the presence
of endothelial dysfunction and systemic inflammation in patients with
obstructive sleep apnea syndrome (OSAS). Continuous positive airway
pressure (CPAP) is the most effective method for treating OSAS;
nonetheless, the effects of CPAP on the aforementioned pathophysiologic
pathways as well as on the systemic disease that result or coexist with
the OSAS remain elusive.
Aim: To assess the effect of 3-month CPAP therapy on
endothelial-dependent dilation, plasma levels of inflammatory markers,
blood pressure (BP), and glucose control on male and female patients
with OSAS.
Methods: Our study group consisted of 40 (24 males and 16 females)
patients with no prior history of cardiovascular disease, with an
apnea-hypopnea index >= 15, who were assigned to receive CPAP treatment.
Measurements of flow-mediated dilation (FMD), 24-hour ambulatory BP, and
blood analysis were performed at baseline and 3 months after CPAP
therapy.
Results: Baseline FMD values were negatively correlated with the
apnea-hypopnea index (r=-0.55, P=0.001). After 3 months of CPAP, there
was an increase in the FMD values (5.40%+/- 2.91% vs 3.13%+/- 3.15%,
P<0.05) and a significant reduction in the patients’ 24-hour systolic BP
(122.82 +/- 11.88 mmHg vs 130.24 +/- 16.75 mmHg, P<0.05), diastolic BP
(75.44 +/- 9.14 mmHg vs 79.68 +/- 11.09 mmHg, P<0.05), and pulse
pressure (47.38 +/- 9.77 mmHg vs 52.72 +/- 11.38 mmHg, P<0.05); daytime
systolic BP (125.76 +/- 12.69 mmHg vs 132.55 +/- 17.00 mmHg, P<0.05) and
diastolic BP (77.88 +/- 10.39 mmHg vs 82.25 +/- 11.01 mmHg, P<0.05);
nighttime systolic BP (118.17 +/- 13.16 mmHg vs 126.22 +/- 17.42 mmHg,
P<0.05) and pulse pressure (46.61 +/- 10.76 mmHg vs 52.66 +/- 11.86
mmHg, P<0.05); and C-reactive protein and HbA1c levels (0.40
[0.40-0.70] mg/L vs 0.60 [0.40-0.84] mg/L and 5.45%+/- 0.70% vs
5.95%+/- 1.08%, respectively; P<0.05). When divided by sex, only male
patients produced similar statistically significant results, while
female patients failed to show such associations.
Conclusion: Our results suggest that CPAP therapy improves the
endothelial function, the BP, and the glucose control in male patients
with OSAS. Further research is warranted in order to verify these
results and to further elucidate the impact of CPAP on the
cardiovascular risk of male and female patients with OSAS.
Συγγραφείς:
Kallianos, Anastasios
Panoutsopoulos, Athanasios
Mermigkis,
Christoforos
Kostopoulos, Konstantinos
Papamichail, Chrysanthi
and Kokkonouzis, Ioannis
Kostopoulos, Christoforos
Nikolopoulos,
Ioannis
Papaiwannou, Antonis
Lampaki, Sofia
Organtzis, John
and Pitsiou, Georgia
Zarogoulidis, Paul
Trakada, Georgia
