Long-term variations of arterial stiffness in patients with obesity and obstructive sleep apnea treated with continuous positive airway pressure

被引:11
作者
Galerneau, Louis-Marie [1 ,2 ]
Bailly, Sebastien [1 ,2 ]
Borel, Jean-Christian [1 ,2 ]
Jullian-Desayes, Ingrid [1 ,2 ]
Joyeux-Faure, Marie [1 ,2 ]
Benmerad, Meriem [1 ,2 ]
Bonsignore, Marisa R. [3 ,4 ]
Tamisier, Renaud [1 ,2 ]
Pepin, Jean-Louis [1 ,2 ]
机构
[1] Univ Grenoble Alpes, HP2 Lab, INSERM U1042, Grenoble, France
[2] Grenoble Alpes Univ Hosp, EFCR Lab, Thorax & Vessels, Grenoble, France
[3] Univ Palermo, PROMISE Dept, Div Resp Med, Palermo, Italy
[4] IBIM CNR, Palermo, Italy
来源
PLOS ONE | 2020年 / 15卷 / 08期
关键词
PULSE-WAVE VELOCITY; EXPERT CONSENSUS DOCUMENT; AORTIC STIFFNESS; CARDIOVASCULAR EVENTS; PULMONARY-DISEASE; BLOOD-PRESSURE; RISK-FACTOR; ALL-CAUSE; CPAP; HYPERTENSION;
D O I
10.1371/journal.pone.0236667
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Obstructive sleep apnea (OSA) is associated with cardiovascular co-morbidities and mortality. Arterial stiffness is an independent predictor of cardiovascular risk and mortality, and is influenced by the presence of OSA and related comorbidities. There is a paucity of data regarding long-term evolution of arterial stiffness in CPAP-treated OSA patients.We aimed to prospectively study long term PWV variations and determinants of PWV deterioration. Methods In a prospective obese OSA cohort, at time of diagnosis and after several years of follow-up we collected arterial stiffness measured by carotid-femoral pulse wave velocity (PWV), clinical and metabolic parameters, and CPAP adherence.Univariate and multivariate analyses were performed in order to determine contributing factors. Results Seventy two OSA patients (men: 52.8%, median age: 55.8 years and median BMI of 38.5 kg/m(2)) with a prevalence of hypertension: 58.3%, type 2 diabetes: 20.8%, hypercholesterolemia: 33.3%, current or past smoking: 59.7%, were evaluated after a median follow-up of 7.4 [5.8; 8.3] years. Over the period of follow-up, the median increase in PWV was 1.34 [0.10; 2.37] m/s. In multivariate analysis, the increase in PWV was associated with older age (10 extra years was associated with a 5.24 [1.35; 9.12] % increase in PWV) and hypertension (a significant increase in PWV of 8.24 [1.02; 15.57] %). No impact of CPAP adherence on PWV evolution was found. Conclusion PWV progression in CPAP-treated OSA patients is mainly related to pre-existing cardio-metabolic comorbidities and not influenced by CPAP adherence. In this high cardiovascular risk population, it is crucial to associated weight management and exercise with CPAP treatment.
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页数:13
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