Effect of CPAP on brachial-ankle pulse wave velocity in patients with OSAHS: an open-labelled study

Respir Med. 2006 Dec;100(12):2160-9. doi: 10.1016/j.rmed.2006.03.015. Epub 2006 May 2.

Abstract

Pulse wave velocity (PWV) is a good indicator of arterial stiffness and an important predictor of cardiovascular events. Recent studies have revealed that PWV increases in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and it also correlates with its severity. However, the therapeutic effect of continuous positive airway pressure (CPAP) on PWV remains undetermined. To clarify this point, we started CPAP treatment on 17 OSAHS patients. Brachial-ankle PWV was measured before starting CPAP, and at 2 months and 4 months after the start of CPAP. Before the CPAP treatment, mean brachial-ankle PWV of the patients was 15.6+/-0.6 m/s, and mean Epworth sleepiness scale (ESS) score was 8.6+/-1.0. Brachial-ankle PWV was found to positively correlate with heart rate, systolic and diastolic blood pressures, mean blood pressure, and arousal index. During the study period, the CPAP treatment did not have a significant effect on heart rate, blood pressures and serum total cholesterol levels. However, it significantly improved ESS score at 4 months after the start of CPAP (P=0.001), while it effectively decreased brachial-ankle PWV at 2 months and at 4 months after the start of CPAP (P=0.010 and P=0.027, respectively). The CPAP treatment was shown to decrease brachial-ankle PWV without affecting blood pressures in OSAHS patients. Although the precise mechanism for this effect is unclear, our finding suggests a close relationship between OSAHS and arterial stiffness, while also reemphasizing the clinical importance of CPAP treatment.

MeSH terms

  • Ankle / blood supply
  • Antihypertensive Agents / therapeutic use
  • Blood Flow Velocity / physiology*
  • Blood Pressure / physiology
  • Brachial Artery / physiology
  • Continuous Positive Airway Pressure / methods*
  • Female
  • Heart Rate / physiology
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy
  • Male
  • Middle Aged
  • Polysomnography / methods
  • Pulsatile Flow / physiology
  • Pulse
  • Sleep Apnea, Obstructive / complications
  • Sleep Apnea, Obstructive / physiopathology*
  • Sleep Apnea, Obstructive / therapy
  • Treatment Outcome

Substances

  • Antihypertensive Agents