Effects of CPAP therapy on the sympathovagal balance and arterial stiffness in obstructive sleep apnea

Summary Objective Increased arterial stiffness and sympathovagal imbalance are noted in patients with obstructive sleep apnea (OSA). It has been thought that continuous positive airway pressure (CPAP) therapy can have beneficial effects on the vascular function in such cases. However, it is not yet...

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Published in:Respiratory medicine 2010-06, Vol.104 (6), p.911-916
Main Authors: Shiina, Kazuki, Tomiyama, Hirofumi, Takata, Yoshifumi, Yoshida, Masanobu, Kato, Kota, Saruhara, Hirokazu, Hashimura, Yuki, Matsumoto, Chisa, Asano, Kihiro, Usui, Yasuhiro, Yamashina, Akira
Format: Article
Language:English
Subjects:
Ankle
Arterial stiffness
Arteries - physiopathology
Autonomic nervous system
Biological and medical sciences
Blood pressure
Blood Pressure - physiology
Cardiovascular disease
Continuous positive airway pressure
Continuous Positive Airway Pressure - methods
Drug therapy
Elasticity - physiology
Endothelium
Female
Heart failure
Heart rate
Heart Rate - physiology
Hospitals
Humans
Male
Medical sciences
Middle Aged
Nitric oxide
Oxidative stress
Plasma
Pneumology
Polysomnography
Pulmonary/Respiratory
Respiratory system : syndromes and miscellaneous diseases
Sleep
Sleep apnea
Sleep Apnea, Obstructive - physiopathology
Sleep Apnea, Obstructive - therapy
Treatment Outcome
Vascular Resistance - physiology
Veins & arteries
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Summary:Summary Objective Increased arterial stiffness and sympathovagal imbalance are noted in patients with obstructive sleep apnea (OSA). It has been thought that continuous positive airway pressure (CPAP) therapy can have beneficial effects on the vascular function in such cases. However, it is not yet clear whether the improvement of sympathovagal balance by CPAP might be related to reduction of the arterial stiffness, independent of changes in the blood pressure. Methods In 50 consecutive eligible patients with OSA (apnea–hypopnea index ≥ 20/hour) receiving CPAP therapy, the brachial-ankle pulse wave velocity (baPWV), heart rate variability (LF, HF and LF/HF ratio), baroreceptor sensitivity (BRS), plasma levels of C-reactive protein (CRP), and endothelial function as assessed by changes in the forearm blood flow before and after reactive hyperemia (END) were measured before and after 3-months' CPAP therapy. Results Significant decrease of the LF/HF ratio, plasma levels of CRP, baPWV and heart rate were observed after 3 months' CPAP therapy. The change in the baPWV following 3-months' CPAP therapy was significantly correlated with the change in the LF/HF ratio and mean blood pressure (MBP), but not with that of the BRS, CRP or END after the therapy. Multivariate linear regression analysis demonstrated a significant correlation between the change in the LF/HF ratio and that in the baPWV (beta = 0.305, p = 0.041), independent of the changes in the MBP, plasma CRP levels and heart rate. Conclusions Improvement of the sympathovagal balance by CPAP therapy may be significantly related to decreased stiffness of the central to middle-sized arteries, independent of the changes in the blood pressure and vascular endothelial status.
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2010.01.010