Changes in extracranial arteries in obstructive sleep apnoea

Abstract

Obstructive sleep apnoea (OSA) is linked with increased cardiovascular morbidity and mortality, possibly through an enhancement of atherosclerotic vascular changes. Up to now, however, only a few studies have tried to evaluate the occurrence of atherosclerosis in patients with OSA.In the present study, ultrasonography of the large extracranial vessels was performed in a group of consecutively admitted OSA patients (n535) and a control group of non-OSA patients (n535). Common carotid artery-intima media thickness (CCA-IMT) was measured at the far wall of both proximal carotid arteries. Furthermore, the presence of plaques and stenoses of the extracranial vessels was determined. All measurements were carried out blinded to the status of the patients.In the OSA group, CCA-IMT was significantly increased when compared with the non-OSA patients and was related to the degree of nocturnal hypoxia. Additionally, the formation of plaques was more pronounced and extracranial vessel stenosis was more common in the OSA patients.In conclusion, these findings are in favour of an independent influence of obstructive sleep apnoea on atherosclerotic changes of the arterial wall, and represent further strong arguments for obstructive sleep apnoea being a risk factor on its own for the emergence of cardiovascular disease.

Structural and functional arterial properties in patients with obstructive sleep apnoea syndrome and cardiovascular comorbidities

“…28 However, we did not find an independent link between the severity of OSAS and carotid plaque formation, although it has been previously described. 18,19 These discordant results possibly reflect the fact that although focal atherogenesis and intima-media thickening share common risk factors they differ in nature. Atherosclerosis is a very complex and multifactorial process in nature and it is not reflected per se by IMT.…”

“…Recent studies have evaluated the effect of OSAS on most of the aforementioned arterial characteristics. [14][15][16][17][18][19][20] These studies demonstrated an increase in carotid IMT and arterial stiffness in patients with OSAS, suggesting that OSAS may promote vascular disease. However, some of these studies excluded patients with cardiovascular or cerebrovascular disease, hypertension, diabetes mellitus, hyperlipidaemia or severe obesity 17,20 and therefore were not representative of the usual population of patients with OSAS encountered in clinical practice who exhibit a high burden of cardiovascular risk factors.…”

“…Carotid IMT, which is considered by many investigators as a surrogate marker for the development of atherosclerosis, as well as an independent predictor of cardiovascular death, 12,22 was shown to be increased in patients with OSAS compared to the control group. 14,15,17,18 Most of these studies, apart from one, 15 have shown that IMT is independently related to the severity of OSAS, as expressed by apnoea-hypopnoea index or nocturnal hypoxaemia. [16][17][18][19] Our data confirm these previous results in a population of patients with numerous cardiovascular comorbidities and further support recent data in humans regarding the independent effect of OSAS in the development of atherosclerosis.…”

“…14,15,17,18 Most of these studies, apart from one, 15 have shown that IMT is independently related to the severity of OSAS, as expressed by apnoea-hypopnoea index or nocturnal hypoxaemia. [16][17][18][19] Our data confirm these previous results in a population of patients with numerous cardiovascular comorbidities and further support recent data in humans regarding the independent effect of OSAS in the development of atherosclerosis. 27 Intermittent repetitive hypoxia has been shown to be associated with increased oxidative stress [8][9][10] and inflammation, 8 which may explain the observed increase in IMT in patients with OSAS.…”

The Influence of Obstructive Sleep Apnea Syndrome on Lipid Metabolism and Atherosclerotic Lesion of Carotid Arteries in Patients With Arterial Hypertension

“…В статье содержатся результаты наблюдений за 150 больными артериальной гипертонией, их которых 75 пациентов с арте-риальной гипертонией и синдромом обструктивного апноэ сна (основная группа) и 75 больных с артериальной гипертонией без синдрома обструктив-ного апноэ (контрольная группа). В данное исследование включены пациенты с различным диапазоном индекса массы тела -от нормальных величин (18,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)9 Aim. To study an interrelation between obstructive sleep apnea syndrome with lipid metabolism disorders and atherosclerotic lesion of carotid arteries in patients with arterial hypertension.…”