help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on June 7, 2007, doi:10.1164/rccm.200703-500OC

Am. J. Respir. Crit. Care Med., Volume 176, Number 7, October 2007, 706-712

A more recent version of this article appeared on October 1, 2007
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200703-500OCv1
176/7/706    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Drager, L. F
Right arrow Articles by Lorenzi-Filho, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Drager, L. F
Right arrow Articles by Lorenzi-Filho, G.

Submitted on March 28, 2007
Accepted on June 7, 2007

Effects of CPAP on Early Signs of Atherosclerosis in Obstructive Sleep Apnea

Luciano F Drager1*, Luiz A Bortolotto1, Adelaide C Figueiredo2, Eduardo M Krieger1, and Geraldo Lorenzi-Filho3

1 Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil, 2 Sleep Laboratory and Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil, 3 Sleep Laboratory and Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil; Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil

* To whom correspondence should be addressed. E-mail: luciano.drager{at}incor.usp.br.

Background: Obstructive sleep apnea (OSA) is associated with adverse cardiovascular outcomes, including myocardial infarction and stroke. Atherosclerosis is a key mechanism for these cardiovascular events. Recent cross-sectional studies showed the presence of early signs of atherosclerosis in OSA patients that were free of comorbidities. However, the impact of treatment with continuous positive airway pressure (CPAP) on atherosclerosis is unknown. Methods: We randomly assigned 24 patients with severe OSA (age: 46±6 years) that were free of comorbidities to receive no treatment (control; n=12) or CPAP (n=12) for 4 months. Carotid intima-media thickness, arterial stiffness (evaluated by pulse wave velocity), carotid diameter, 24-hour blood pressure monitoring, C-reactive protein, and catecholamines were determined at baseline and after 4 months. Results: At baseline, all measurements were similar in both groups and did not change in the control group after 4 months. In contrast, a significant decrease occurred in carotid intima-media thickness (707±105 vs. 645±95 µm; P=0.04), pulse wave velocity (10.4±1.0 vs. 9.3±0.9 m/s; P<0.001), C-reactive protein (3.7±1.8 vs. 2.0±1.2 mg/L; P=0.001), and catecholamines (365±125 vs. 205±51 ng/mL; P<0.001) after 4 months of CPAP. Carotid diameter did not change significantly. Regarding the whole group, changes in carotid intima-media thickness were correlated with changes in catecholamines (r=0.41; P<0.05). Changes in pulse wave velocity were correlated with changes in C-reactive protein (r=0.58; P<0.01) and catecholamines (r=0.54; P<0.01). Conclusions: The treatment of OSA significantly improves early signs of atherosclerosis, supporting the concept that OSA is an independent risk factor for atherosclerosis. ClinicalTrials.gov number,NCT00400543 [ClinicalTrials.gov]
Key words: obstructive sleep apnea; intima-media thickness; arterial stiffness; atherosclerosis; continuous positive airway pressure




This article has been cited by other articles:


Home page
 J Am Coll CardiolHome page
M. F. Eleid, T. Konecny, M. Orban, P. P. Sengupta, V. K. Somers, J. M. Parish, F. Mookadam, P. A. Brady, B. L. Sullivan, B. K. Khandheria, et al.
High prevalence of abnormal nocturnal oximetry in patients with hypertrophic cardiomyopathy.
J. Am. Coll. Cardiol., November 3, 2009; 54(19): 1805 - 1809.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. J. Lettieri, J. F. Collen, A. H. Eliasson, and T. M. Quast
Sedative Use During Continuous Positive Airway Pressure Titration Improves Subsequent Compliance: A Randomized, Double-Blind, Placebo-Controlled Trial
Chest, November 1, 2009; 136(5): 1263 - 1268.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
T. Kumagai, T. Kasai, M. Kato, R. Naito, K.-i. Maeno, S. Kasagi, F. Kawana, S. Ishiwata, and K. Narui
Establishment of the Cardio-Ankle Vascular Index in Patients With Obstructive Sleep Apnea
Chest, September 1, 2009; 136(3): 779 - 786.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
P. Levy, M. R. Bonsignore, and J. Eckel
Sleep, sleep-disordered breathing and metabolic consequences
Eur. Respir. J., July 1, 2009; 34(1): 243 - 260.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
L. Lavie and P. Lavie
Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link
Eur. Respir. J., June 1, 2009; 33(6): 1467 - 1484.
[Abstract] [Full Text] [PDF]

Home page
 ERRHome page
M. R. Bonsignore and J. Eckel
Metabolic aspects of obstructive sleep apnoea syndrome
Eur. Respir. Rev., June 1, 2009; 18(112): 113 - 124.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
F. Roche, J-M. Gaspoz, V. Pichot, M. Picard-Kossovsky, D. Maudoux, A. Garcin, S. Celle, E. Sforza, J. C. Barthelemy, and on behalf of the PROOF and SYNAPSE Study Groups
Association between C-reactive protein and unrecognised sleep-disordered breathing in the elderly
Eur. Respir. J., April 1, 2009; 33(4): 797 - 803.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. M.-s. Lui, J. C.-m. Lam, H. K.-F. Mak, A. Xu, C. Ooi, D. C.-l. Lam, J. C.-w. Mak, P. L. Khong, and M. S.-M. Ip
C-Reactive Protein Is Associated With Obstructive Sleep Apnea Independent of Visceral Obesity
Chest, April 1, 2009; 135(4): 950 - 956.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. Collen, C. Lettieri, W. Kelly, and S. Roop
Clinical and Polysomnographic Predictors of Short-Term Continuous Positive Airway Pressure Compliance
Chest, March 1, 2009; 135(3): 704 - 709.
[Abstract] [Full Text] [PDF]

Home page
 ACCP Sleep Med Brd RevHome page
H. K. Yaggi
Sleep and the Cardiovascular System
ACCP Sleep Med Brd Rev, January 1, 2009; 4(0): 123 - 132.
[Full Text] [PDF]

Home page
 ThoraxHome page
M Kohler, L Ayers, J C T Pepperell, K L Packwood, B Ferry, N Crosthwaite, S Craig, M M Siccoli, R J O Davies, and J R Stradling
Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial
Thorax, January 1, 2009; 64(1): 67 - 73.
[Abstract] [Full Text] [PDF]

Home page
 HypertensionHome page
J. S. Floras
Hypertension, Sleep Apnea, and Atherosclerosis
Hypertension, January 1, 2009; 53(1): 1 - 3.
[Full Text] [PDF]

Home page
 HypertensionHome page
L. F. Drager, L. A. Bortolotto, E. M. Krieger, and G. Lorenzi-Filho
Additive Effects of Obstructive Sleep Apnea and Hypertension on Early Markers of Carotid Atherosclerosis
Hypertension, January 1, 2009; 53(1): 64 - 69.
[Abstract] [Full Text] [PDF]

Home page
 Circ. Res.Home page
V. Savransky, J. Jun, J. Li, A. Nanayakkara, S. Fonti, A. B. Moser, K. E. Steele, M. A. Schweitzer, S. P. Patil, S. Bhanot, et al.
Dyslipidemia and Atherosclerosis Induced by Chronic Intermittent Hypoxia Are Attenuated by Deficiency of Stearoyl Coenzyme A Desaturase
Circ. Res., November 7, 2008; 103(10): 1173 - 1180.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
G. Lorenzi-Filho and L. F. Drager
Is the Cardiovascular System the Primary Target of Obstructive Sleep Apnea?
Am. J. Respir. Crit. Care Med., November 1, 2008; 178(9): 892 - 893.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
P. Levy, J-L. Pepin, C. Arnaud, R. Tamisier, J-C. Borel, M. Dematteis, D. Godin-Ribuot, and C. Ribuot
Intermittent hypoxia and sleep-disordered breathing: current concepts and perspectives
Eur. Respir. J., October 1, 2008; 32(4): 1082 - 1095.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
J. Jun, V. Savransky, A. Nanayakkara, S. Bevans, J. Li, P. L. Smith, and V. Y. Polotsky
Intermittent hypoxia has organ-specific effects on oxidative stress
Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2008; 295(4): R1274 - R1281.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
M. Moss
Clinical Year in Review I: Lung Cancer, Pleural Disease, Exercise Testing and Pulmonary Rehabilitation, and Sleep Medicine
Proceedings of the ATS, September 15, 2008; 5(7): 739 - 744.
[Full Text] [PDF]

Home page
 CirculationHome page
F. Valham, T. Mooe, T. Rabben, H. Stenlund, U. Wiklund, and K. A. Franklin
Increased Risk of Stroke in Patients With Coronary Artery Disease and Sleep Apnea: A 10-Year Follow-Up
Circulation, August 26, 2008; 118(9): 955 - 960.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Endocrinol. Metab.Home page
G. Carneiro, S. M. Togeiro, L. F. Hayashi, F. F. Ribeiro-Filho, A. B. Ribeiro, S. Tufik, and M. T. Zanella
Effect of continuous positive airway pressure therapy on hypothalamic-pituitary-adrenal axis function and 24-h blood pressure profile in obese men with obstructive sleep apnea syndrome
Am J Physiol Endocrinol Metab, August 1, 2008; 295(2): E380 - E384.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
B. Lefebvre, J-L. Pepin, J-P. Baguet, R. Tamisier, M. Roustit, K. Riedweg, G. Bessard, P. Levy, and F. Stanke-Labesque
Leukotriene B4: early mediator of atherosclerosis in obstructive sleep apnoea?
Eur. Respir. J., July 1, 2008; 32(1): 113 - 120.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. L. Phillips, B. Yee, Q. Yang, A. T. Villaneuva, J. Hedner, N. Berend, and R. Grunstein
Effects of Continuous Positive Airway Pressure Treatment and Withdrawal in Patients With Obstructive Sleep Apnea on Arterial Stiffness and Central BP
Chest, July 1, 2008; 134(1): 94 - 100.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. Gozal, O. S. Capdevila, and L. Kheirandish-Gozal
Metabolic Alterations and Systemic Inflammation in Obstructive Sleep Apnea among Nonobese and Obese Prepubertal Children
Am. J. Respir. Crit. Care Med., May 15, 2008; 177(10): 1142 - 1149.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. L. Horner and T. D. Bradley
Update in Sleep and Control of Ventilation 2007
Am. J. Respir. Crit. Care Med., May 1, 2008; 177(9): 947 - 951.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. D. Bradley
Respiratory Sleep Medicine: A Coming of Age
Am. J. Respir. Crit. Care Med., February 15, 2008; 177(4): 363 - 364.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. Gozal and L. Kheirandish-Gozal
Cardiovascular Morbidity in Obstructive Sleep Apnea: Oxidative Stress, Inflammation, and Much More
Am. J. Respir. Crit. Care Med., February 15, 2008; 177(4): 369 - 375.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. Yumino and T. D. Bradley
Pathogenesis of Atherosclerosis: Is Obstructive Sleep Apnea the New Kid on the Block?
Am. J. Respir. Crit. Care Med., October 1, 2007; 176(7): 634 - 635.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2007 American Thoracic Society 		  CCM abstracts