Continuous positive nasal airway pressure decreases levels of serum amyloid A and improves autonomic function in obstructive sleep apnea syndrome

Kuramoto, Emi; Kinami, Saori; Ishida, Yoshihiro; Shiotani, Hideyuki; Nishimura, Yoshihiro

doi:10.1016/j.ijcard.2008.03.078

Cited by 27 publications

(18 citation statements)

References 35 publications

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“…[11][12][13][14][15] In the present Long-term effect of CPAP for PWV in sleep apnea T Saito et al study, PWV in both NT and HT patients decreased initially before increasing gradually: during the initial 6 months of treatment, PWV decreased significantly and then increased gradually over the next 18 months. Despite the gradual increase in PWV over the final 18 months of treatment, PWV after 2 years of CPAP in both groups remained below baseline values.…”

Section: Discussionmentioning

confidence: 48%

“…10 A few recent studies showed that CPAP effectively improved PWV when used for short periods of time. [11][12][13][14][15] However, the long-term effects of CPAP on PWV remain unclear. Previous studies of the short-term effects of CPAP on PWV were performed in normotensive (NT) OSA patients; thus, the effects of CPAP on PWV in patients with HT are unknown.…”

Section: Introductionmentioning

confidence: 99%

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Effects of long-term treatment for obstructive sleep apnea on pulse wave velocity

Saito

Sugiyama

et al. 2010

Hypertens Res

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Continuous positive airway pressure (CPAP) treatment improves endothelial function and sympathetic activity in patients with obstructive sleep apnea (OSA). However, the long-term effects of CPAP on pulse wave velocity (PWV), which reflects arterial stiffness that is associated with cardiovascular events, have not been evaluated in OSA patients with or without hypertension (HT). In this study, 212 male OSA patients who had been receiving CPAP treatment for 2 years and were divided into two groups, those with HT (n¼114) and those without (n¼98), were studied. In both HT and normotensive (NT) patients, PWV decreased significantly over the first 6 months of treatment (P¼0.005 and 0.010, respectively), before increasing gradually from 6 to 24 months. Body mass index (BMI), body weight, heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels decreased significantly in the HT group over the 2 years of CPAP treatment (Po0.001 for all). In contrast, only HR decreased significantly in the NT group over the 2 years of treatment (Po0.001). Multivariate regression analysis revealed that age (P¼0.008), decreases in DBP (Po0.001) and HR (Po0.001) and higher initial levels of serum high-density lipoprotein-cholesterol (P¼0.040) were independent factors related to changes in PWV over the 2 years of CPAP treatment in all patients. In conclusion, we found a significant decrease in PWV in both NT and HT patients after 6 months of CPAP treatment. In HT patients, long-term CPAP treatment significantly decreases blood pressure, which may contribute to explain the PWV improvement.

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Section: Discussionmentioning

confidence: 48%

Section: Introductionmentioning

confidence: 99%

Effects of long-term treatment for obstructive sleep apnea on pulse wave velocity

Saito

Sugiyama

et al. 2010

Hypertens Res

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“…58,59 Similar findings have also been reported from other studies evaluating OSA treatment effects on arterial stiffness which did not meet our inclusion criteria. 68 Also of note, Phillips et al 61 found that 8 weeks of CPAP treatment lead to reductions in AIx and central systolic blood pressure without a concomitant decrease in peripheral blood pressure. Thus, although the numbers are relatively small in the randomized studies to date, and further larger studies are required with longer follow-up of both arterial stiffness and cardiovascular event outcomes, the current literature points to an independent association between OSA and arterial stiffness.…”

Section: Discussionmentioning

confidence: 99%

Increased arterial stiffness in obstructive sleep apnea: a systematic review

et al. 2010

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Obstructive sleep apnea is a prevalent disease that is associated with significant morbidity and mortality, particularly due to cardiovascular disease. An emerging cardiovascular risk factor, arterial stiffness, may also be involved in the cardiovascular complications of obstructive sleep apnea. The purpose of this review was to summarize the current literature regarding the effect of obstructive sleep apnea on arterial stiffness. We conducted a systematic literature review using PubMed, Embase and the Cochrane Library. We identified 24 studies that met search criteria investigating the effect of obstructive sleep apnea on arterial stiffness. Arterial stiffness was found to be increased in obstructive sleep apnea patients compared with controls or increased in severe compared with mild sleep apnea. In some studies, a positive correlation was identified between the degree of arterial stiffness and sleep apnea severity. In the two randomized, controlled trials and the two nonrandomized trials identified, treatment of obstructive sleep apnea with continuous positive airway pressure led to significant decreases in arterial stiffness. Obstructive sleep apnea appears to have an independent effect on arterial stiffness, which may be one of the mechanisms accounting for sleep apnea-associated cardiovascular risk.

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“…106 Recent studies have found that circulating TNF-α, serum amyloid A, CRP, IL-6, IL-8, ICAM-1, VCAM-1, TNF-α, and E-selectin significantly increase in patients with OSA. [107][108][109][110] OSA is also associated with increased platelet activation and aggregability, markers of thrombosis. Bokinsky et al found a significant increase in platelet aggregation and activation in patients with OSA during the night compared with presleep, and noted a marked reduction in these measures following the application of CPAP.…”

Section: Cadmentioning

confidence: 99%