Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Sleep and Breathing
Published in: Sleep and Breathing 1/2011

01-01-2011 | Original Article

The effects of nasal continuous positive airway pressure on vascular functions and serum cardiovascular risk factors in obstructive sleep apnea syndrome

Authors: Seockhoon Chung, In-Young Yoon, Chul Hee Lee, Jeong-Whun Kim

Published in: Sleep and Breathing | Issue 1/2011

Login to get access

Abstract

Purpose

We investigated whether the nasal continuous positive airway pressure (nCPAP) could have impacts on impaired vascular functions and serum cardiovascular risk factors in obstructive sleep apnea syndrome (OSAS).

Methods

We enrolled 25 OSAS patients of moderate to severe degree. After polysomnography, carotid-femoral pulse wave velocity (cfPWV) and flow-mediated dilation (FMD) were measured. Also, serum levels of C-reactive protein (CRP), total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, glucose, and insulin were measured. After nCPAP treatment (mean duration, 138.7 ± 42.6 days), these tests were performed again.

Results

The mean apnea hypopnea index prior to nCPAP was 64.9 ± 20.0/h, which decreased to 4.1 ± 2.0/h with nCPAP (p < 0.001). After nCPAP, cfPWV (m/s) decreased from 11.2 ± 4.5 to 9.3 ± 2.1 (p = 0.031), and FMD (%) was improved from 5.52 ± 2.49 to 6.58 ± 2.50 (p = 0.006). Body mass index, serum levels of CRP, total cholesterol, triglyceride, HDL cholesterol, or glucose did not change after nCPAP. Insulin resistance was not improved either.

Conclusions

The cfPWV and FMD were significantly improved after nCPAP treatment, even though there was no significant change in body weight or serum cardiovascular risk factors. The nCPAP treatment could decrease risks of cardiovascular complications in OSAS patients through improving vascular functions.
Literature
1.
Hermann DM, Bassetti CL (2003) Sleep-disordered breathing and stroke. Curr Opin Neurol 16(1):87–90PubMedCrossRef
2.
Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, O’Connor GT, Boland LL, Schwartz JE, Samet JM (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 163(1):19–25PubMedCrossRef
3.
4.
Gozal D, Kheirandish-Gozal L (2008) Cardiovascular morbidity in obstructive sleep apnea: oxidative stress, inflammation, and much more. Am J Respir Crit Care Med 177(4):369–375PubMedCrossRef
5.
Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353(19):2034–2041PubMedCrossRef
6.
Nurnberger J, Kribben A, Philipp T, Erbel R (2007) Arterial compliance (stiffness) as a marker of subclinical atherosclerosis. Herz 32(5):379–386PubMedCrossRef
7.
8.
Drager LF, Bortolotto LA, Lorenzi MC, Figueiredo AC, Krieger EM, Lorenzi-Filho G (2005) Early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 172(5):613–618PubMedCrossRef
9.
Ip MS, Tse HF, Lam B, Tsang KW, Lam WK (2004) Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med 169(3):348–353PubMedCrossRef
10.
Nagahama H, Soejima M, Uenomachi H, Higashi Y, Yotsumoto K, Samukawa T, Arima T (2004) Pulse wave velocity as an indicator of atherosclerosis in obstructive sleep apnea syndrome patients. Intern Med 43(3):184–188PubMedCrossRef
11.
Nieto FJ, Herrington DM, Redline S, Benjamin EJ, Robbins JA (2004) Sleep apnea and markers of vascular endothelial function in a large community sample of older adults. Am J Respir Crit Care Med 169(3):354–360PubMedCrossRef
12.
Chung S, Yoon IY, Lee CH, Kim JW (2009) The association of nocturnal hypoxemia with arterial stiffness and endothelial dysfunction in male patients with obstructive sleep apnea syndrome. Respiration (in press)
13.
Chung S, Yoon IY, Shin YK, Lee CH, Kim JW, Lee T, Choi DJ, Ahn HJ (2007) Endothelial dysfunction and C-reactive protein in relation with the severity of obstructive sleep apnea syndrome. Sleep 30(8):997–1001PubMed
14.
Ip MS, Lam B, Ng MM, Lam WK, Tsang KW, Lam KS (2002) Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 165(5):670–676PubMedCrossRef
15.
Punjabi NM, Beamer BA (2007) C-reactive protein is associated with sleep disordered breathing independent of adiposity. Sleep 30(1):29–34PubMed
16.
Borgel J, Sanner BM, Bittlinsky A, Keskin F, Bartels NK, Buechner N, Huesing A, Rump LC, Mugge A (2006) Obstructive sleep apnoea and its therapy influence high-density lipoprotein cholesterol serum levels. Eur Respir J 27(1):121–127PubMedCrossRef
17.
Comondore VR, Cheema R, Fox J, Butt A, John Mancini GB, Fleetham JA, Ryan CF, Chan S, Ayas NT (2009) The impact of CPAP on cardiovascular biomarkers in minimally symptomatic patients with obstructive sleep apnea: a pilot feasibility randomized crossover trial. Lung 187(1):17–22PubMedCrossRef
18.
Cross MD, Mills NL, Al-Abri M, Riha R, Vennelle M, Mackay TW, Newby DE, Douglas NJ (2008) Continuous positive airway pressure improves vascular function in obstructive sleep apnoea/hypopnoea syndrome: a randomised controlled trial. Thorax 63(7):578–583PubMedCrossRef
19.
Drager LF, Bortolotto LA, Figueiredo AC, Krieger EM, Lorenzi GF (2007) Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 176(7):706–712PubMedCrossRef
20.
Phillips CL, Yee B, Yang Q, Villaneuva AT, Hedner J, Berend N, Grunstein R (2008) Effects of continuous positive airway pressure treatment and withdrawal in patients with obstructive sleep apnea on arterial stiffness and central BP. Chest 134(1):94–100PubMedCrossRef
21.
Vgontzas AN (2008) Does obesity play a major role in the pathogenesis of sleep apnoea and its associated manifestations via inflammation, visceral adiposity, and insulin resistance? Arch Physiol Biochem 114(4):211–223PubMedCrossRef
22.
Rechtschaffen A, Kales A (1968) A manual of standardized terminology, technique, and scoring system for sleep stages of human subjects. Los Angeles: Brain Information Service/Brain Research Institute, UCLA
23.
Gould GA, Whyte KF, Rhind GB, Airlie MA, Catterall JR, Shapiro CM, Douglas NJ (1988) The sleep hypopnea syndrome. Am Rev Respir Dis 137(4):895–898PubMedCrossRef
24.
Asmar R, Benetos A, Topouchian J, Laurent P, Pannier B, Brisac AM, Target R, Levy BI (1995) Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies. Hypertension 26(3):485–490PubMedCrossRef
25.
Yu WC, Chuang SY, Lin YP, Chen CH (2008) Brachial-ankle vs carotid-femoral pulse wave velocity as a determinant of cardiovascular structure and function. J Hum Hypertens 22(1):24–31PubMedCrossRef
26.
Frank O (1927) Die Theorie der Pulswellen. Z Biol 85:91–130
27.
Faulx MD, Wright AT, Hoit BD (2003) Detection of endothelial dysfunction with brachial artery ultrasound scanning. Am Heart J 145(6):943–951PubMedCrossRef
28.
Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, Peter JH (2003) Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 107(1):68–73PubMedCrossRef
29.
Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053PubMed
30.
Minoguchi K, Yokoe T, Tazaki T, Minoguchi H, Oda N, Tanaka A, Yamamoto M, Ohta S, O’Donnell CP, Adachi M (2007) Silent brain infarction and platelet activation in obstructive sleep apnea. Am J Respir Crit Care Med 175(6):612–617PubMedCrossRef
31.
Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, Ducimetiere P, Benetos A (2001) Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 37(5):1236–1241PubMedCrossRef
32.
Kobayashi K, Akishita M, Yu W, Hashimoto M, Ohni M, Toba K (2004) Interrelationship between non-invasive measurements of atherosclerosis: flow-mediated dilation of brachial artery, carotid intima-media thickness and pulse wave velocity. Atherosclerosis 173(1):13–18PubMedCrossRef
33.
Wallace SM, Yasmin McEniery CM, Maki-Petaja KM, Booth AD, Cockcroft JR, Wilkinson IB (2007) Isolated systolic hypertension is characterized by increased aortic stiffness and endothelial dysfunction. Hypertension 50(1):228–233PubMedCrossRef
34.
Lavie L (2003) Obstructive sleep apnoea syndrome—an oxidative stress disorder. Sleep Med Rev 7(1):35–51PubMedCrossRef
35.
Teramoto S, Kume H, Matsuse T, Ishii T, Miyashita A, Akishita M, Toba K, Ouchi Y (2003) Oxygen administration improves the serum level of nitric oxide metabolites in patients with obstructive sleep apnea syndrome. Sleep Med 4(5):403–407PubMedCrossRef
36.
Coughlin SR, Mawdsley L, Mugarza JA, Wilding JP, Calverley PM (2007) Cardiovascular and metabolic effects of CPAP in obese males with OSA. Eur Respir J 29(4):720–727PubMedCrossRef
37.
Schahin SP, Nechanitzky T, Dittel C, Fuchs FS, Hahn EG, Konturek PC, Ficker JH, Harsch IA (2008) Long-term improvement of insulin sensitivity during CPAP therapy in the obstructive sleep apnoea syndrome. Med Sci Monit 14(3):CR117–CR121PubMed
38.
Trenell MI, Ward JA, Yee BJ, Phillips CL, Kemp GJ, Grunstein RR, Thompson CH (2007) Influence of constant positive airway pressure therapy on lipid storage, muscle metabolism and insulin action in obese patients with severe obstructive sleep apnoea syndrome. Diabetes Obes Metab 9(5):679–687PubMedCrossRef
39.
Kohler M, Ayers L, Pepperell JC, Packwood KL, Ferry B, Crosthwaite N, Craig S, Siccoli MM, Davies RJ, Stradling JR (2009) Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial. Thorax 64(1):67–73PubMedCrossRef
40.
Steiropoulos P, Tsara V, Nena E, Fitili C, Kataropoulou M, Froudarakis M, Christaki P, Bouros D (2007) Effect of continuous positive airway pressure treatment on serum cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea syndrome. Chest 132(3):843–851PubMedCrossRef
41.
Sharma SK, Kumpawat S, Goel A, Banga A, Ramakrishnan L, Chaturvedi P (2007) Obesity, and not obstructive sleep apnea, is responsible for metabolic abnormalities in a cohort with sleep-disordered breathing. Sleep Med 8(1):12–17PubMedCrossRef
42.
Stoohs RA, Facchini F, Guilleminault C (1996) Insulin resistance and sleep-disordered breathing in healthy humans. Am J Respir Crit Care Med 154(1):170–174PubMedCrossRef
43.
Guilleminault C, Kirisoglu C, Ohayon MM (2004) C-reactive protein and sleep-disordered breathing. Sleep 27(8):1507–1511PubMed
Metadata
Title
The effects of nasal continuous positive airway pressure on vascular functions and serum cardiovascular risk factors in obstructive sleep apnea syndrome
Authors
Seockhoon Chung
In-Young Yoon
Chul Hee Lee
Jeong-Whun Kim
Publication date
01-01-2011
Publisher
Springer Berlin Heidelberg
Published in
Sleep and Breathing / Issue 1/2011
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-009-0323-x

Other articles of this Issue 1/2011

Sleep and Breathing 1/2011 Go to the issue

Society News

‘Snoring and the role of the dental practitioner’

Original Article

A 2-week, polysomnographic, safety study of sodium oxybate in obstructive sleep apnea syndrome

Original Article

Auto bi-level with pressure relief during exhalation as a rescue therapy for optimally treated obstructive sleep apnoea patients with poor compliance to continuous positive airways pressure therapy—a pilot study

Original Article

Sleep-disordered breathing, behavior, and academic performance in Taiwan schoolchildren

SOCIETY NEWS

American Academy of Dental Sleep Medicine Continuing Education offerings

Original Article

Comparing the Berlin and the ARES questionnaire to identify patients with obstructive sleep apnea in a dental setting
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits