Associations Between Obstructive Sleep Apnea and Measures of Arterial Stiffness.

STUDY OBJECTIVES The aim of this study was to determine whether severity measures of obstructive sleep apnea (OSA) are associated with arterial stiffness and central blood pressure (two important cardiovascular risk factors) in a large group of patients with OSA. METHODS Baseline data from six studies on OSA in which arterial stiffness and central aortic blood pressure measures were determined using applanation tonometry were pooled. Associations between measures of arterial stiffness (heart rate corrected augmentation index [AI75]), central aortic blood pressure (central systolic pressure [CSP] and heart rate corrected central augmentation pressure [CAP75]) and measures of OSA severity were explored using stepwise regression modelling. RESULTS Data from 362 participants (M:F ratio 13:1) with mean (standard deviation) age 49.2 (11.0) years, body mass index 31.9 (5.3) kg/m2, apnea-hypopnea index (AHI) 35.7 (20.7) events/h were included in the analyses. The AHI, oxygen desaturation index (ODI3%), and sleep time with SpO2 < 90% (T90) were all associated with arterial stiffness (AI75), (AHI: adj. β = .069; P = .01; ODI3%: adj. β = .072; P = .01; T90: adj. β = .18; P < .0001) and CAP75 (AHI: adj. β = .030; P = .01; ODI3%: adj. β = .027; P = .02; T90: adj. β = .080; P < .0001). AHI was also associated with CSP (AHI: adj. β = .11; P = .002). CONCLUSIONS OSA severity was significantly associated with augmentation index and CAP75 although the relationships were not strong.

[1]  D. Celermajer,et al.  Randomized Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men With Obstructive Sleep Apnea and Erectile Dysfunction , 2018, The Journal of clinical endocrinology and metabolism.

[2]  Xiaofang Chen,et al.  Effect of continuous positive airway pressure on arterial stiffness in patients with obstructive sleep apnea and hypertension: a meta-analysis , 2016, European Archives of Oto-Rhino-Laryngology.

[3]  Fernando Martinez,et al.  Pulse pressure amplification and its determinants , 2016, Blood pressure.

[4]  C. Hoyos,et al.  Treatment of Sleep Apnea With CPAP Lowers Central and Peripheral Blood Pressure Independent of the Time-of-Day: A Randomized Controlled Study. , 2015, American journal of hypertension.

[5]  S. Craig,et al.  Effect of CPAP on arterial stiffness in severely obese patients with obstructive sleep apnoea , 2015, Sleep and Breathing.

[6]  S. Craig,et al.  Obstructive sleep apnea is associated with increased arterial stiffness in severe obesity , 2014, Journal of sleep research.

[7]  S. Laurent,et al.  Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors. , 2014, European heart journal.

[8]  E. Lakatta,et al.  Hypertension Derivation and Validation of Diagnostic Thresholds for Central Blood Pressure Measurements Based on Long-Term Cardiovascular Risks , 2022 .

[9]  D. Newby,et al.  Arterial stiffness and endothelial function in obstructive sleep apnoea/hypopnoea syndrome. , 2013, Sleep medicine.

[10]  G. Marks,et al.  Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. , 2013, American journal of respiratory and critical care medicine.

[11]  A. Avolio,et al.  Is obstructive sleep apnoea causally related to arterial stiffness? A critical review of the experimental evidence. , 2013, Sleep medicine reviews.

[12]  C. Stefanadis,et al.  Effects of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea in arterial stiffness: a meta-analysis. , 2013, Sleep medicine reviews.

[13]  C. Hoyos,et al.  Body compositional and cardiometabolic effects of testosterone therapy in obese men with severe obstructive sleep apnoea: a randomised placebo-controlled trial. , 2012, European journal of endocrinology.

[14]  C. Hoyos,et al.  Cardiometabolic changes after continuous positive airway pressure for obstructive sleep apnoea: a randomised sham-controlled study , 2012, Thorax.

[15]  A. Wykrętowicz,et al.  Pulse pressure amplification in relation to body fatness. , 2012, British journal of clinical pharmacology.

[16]  N. Marshall,et al.  Continuous positive airway pressure reduces postprandial lipidemia in obstructive sleep apnea: a randomized, placebo-controlled crossover trial. , 2011, American journal of respiratory and critical care medicine.

[17]  J. Kals,et al.  Differential Effects of Nebivolol and Metoprolol on Central Aortic Pressure and Left Ventricular Wall Thickness , 2011, Hypertension.

[18]  T Douglas Bradley,et al.  Obstructive sleep apnea and heart failure: pathophysiologic and therapeutic implications. , 2011, Journal of the American College of Cardiology.

[19]  C. Vlachopoulos,et al.  Prediction of Cardiovascular Events and All-Cause Mortality With Arterial Stiffness , 2011 .

[20]  Michael J. Pencina,et al.  Arterial Stiffness and Cardiovascular Events: The Framingham Heart Study , 2010, Circulation.

[21]  J. Vestbo,et al.  Aortic augmentation index: reference values in a large unselected population by means of the SphygmoCor device. , 2010, American journal of hypertension.

[22]  Seockhoon Chung,et al.  The Association of Nocturnal Hypoxemia with Arterial Stiffness and Endothelial Dysfunction in Male Patients with Obstructive Sleep Apnea Syndrome , 2009, Respiration.

[23]  J. Cruickshank,et al.  Arterial Stiffness, Fatness, and Physical Fitness: Ready for Intervention in Childhood and Across the Life Course? , 2009, Hypertension.

[24]  J. Pépin,et al.  Obstructive sleep apnea and atherosclerosis. , 2009, Progress in cardiovascular diseases.

[25]  Allan I Pack,et al.  Obstructive sleep apnea and cardiovascular disease: a perspective and future directions. , 2009, Progress in cardiovascular diseases.

[26]  J. Stradling,et al.  CPAP and measures of cardiovascular risk in males with OSAS , 2008, European Respiratory Journal.

[27]  R. Basner.  Faculty Opinions recommendation of Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. , 2008 .

[28]  T. Young,et al.  Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. , 2008, Sleep.

[29]  J. Hedner,et al.  Diurnal and obstructive sleep apnea influences on arterial stiffness and central blood pressure in men. , 2005, Sleep.

[30]  Jose M Marin,et al.  Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study , 2005, The Lancet.

[31]  P. Ducimetiere,et al.  Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients , 2001, Hypertension.

[32]  Daniel J Buysse,et al.  Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. , 1999, Sleep.

[33]  K Maie,et al.  Correlation of ultrasound-measured common carotid artery stiffness with pathological findings. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[34]  E. Wolpert.  A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .

[35]  C. Tsioufis,et al.  Subendocardial viability ratio as an index of impaired coronary flow reserve in hypertensives without significant coronary artery stenoses , 2012, Journal of Human Hypertension.

[36]  W. Elliott.  High Central Pulse Pressure Is Independently Associated With Adverse Cardiovascular Outcome: The Strong Heart Study , 2010 .

[37]  J. Hedner,et al.  The effect of sibutramine-assisted weight loss in men with obstructive sleep apnoea , 2007, International Journal of Obesity.

[38]  Erry,et al.  Prospective study of the association between sleep-disordered breathing and hypertension. , 2000, The New England journal of medicine.