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

Shiina, Kazuki; Tomiyama, Hirofumi; Takata, Yasuyuki; Yoshida, Masanobu; Kato, Kota; Saruhara, Hirokazu; Hashimura, Yuki; Matsumoto, Chisa; Asano, Katsuaki; Usui, Yasuhiro; Yamashina, Akira

doi:10.1016/j.rmed.2010.01.010

Cited by 45 publications

(37 citation statements)

References 36 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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“…Furthermore, they found a significant correlation between the severity of sleep apnea, as measured by arousal index, and baPWV. Similarly, Shiina et al 63 found 3 months of CPAP to lead to a significant decrease in baPWV but not peripheral blood pressure. Saito et al, 64 however, found 6 months of CPAP treatment to decrease both baPWV and peripheral blood pressure in both hypertensive and normotensive patients.…”

Section: Resultsmentioning

confidence: 90%

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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“…Sleep apnea is also a risk factor for accelerated increase of the brachial-ankle PWV 32,33) . Sympathetic nervous activation induced by hypoxia resulting from apnea may be one of the mechanisms underlying the accelerated increase of the arterial stiffness in subjects with sleep apnea 34) . Although several cross- 46) , subclinical cerebral damage 47) , cognitive dysfunction 48) , renal dysfunction 49,50) , cardiac diastolic dysfunction 51) , left ventricular hypertrophy 52) , and/or increased carotid intima-media thickness 53) ].…”

Section: Metabolic Syndrome Sleep Apnea and Obesitymentioning

confidence: 99%

Brachial-Ankle PWV: Current Status and Future Directions as a Useful Marker in the Management of Cardiovascular Disease and/or Cardiovascular Risk Factors

Tomiyama

Matsumoto

Shiina

et al. 2016

J Atheroscler Thromb

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Since 2001, brachial-ankle pulse wave velocity (brachial-ankle PWV) measurement has been applied for risk stratification of patients with atherosclerotic cardiovascular disease and/or its risk factors in Japan. Measurement of the brachial-ankle PWV is simple and well standardized, and its reproducibility and accuracy are acceptable. Several cross-sectional studies have demonstrated a significant correlation between the brachial-ankle PWV and known risk factors for cardiovascular disease; the correlation is stronger in subjects with cardiovascular disease than in those without cardiovascular disease. We conducted a meta-analysis, which demonstrated that the brachial-ankle PWV is an independent predictor of future cardiovascular events. Furthermore, the treatment of cardiovascular risk factors and lifestyle modifications have been shown to improve the brachial-ankle PWV. Thus, at present, brachial-ankle PWV is close to being considered as a useful marker in the management of atherosclerotic cardiovascular disease and/or its risk factors.

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

Abstract: 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.

Cited by 45 publications

References 36 publications

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

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

Increased arterial stiffness in obstructive sleep apnea: a systematic review

Brachial-Ankle PWV: Current Status and Future Directions as a Useful Marker in the Management of Cardiovascular Disease and/or Cardiovascular Risk Factors

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