Open AccessLong-term variations of arterial stiffness in patients with obesity and obstructive sleep apnea treated with continuous positive airway pressure
Author(s) -
LouisMarie Galerneau,
Sébastien Bailly,
Jean-Christian Borel,
Ingrid JullianDesayes,
Marie JoyeuxFaure,
Mériem Benmerad,
Marisa Bonsignore,
Renaud Tamisier,
JeanLouis Pépin
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0236667
Subject(s) - medicine , arterial stiffness , pulse wave velocity , obstructive sleep apnea , cardiology , continuous positive airway pressure , blood pressure , prospective cohort study , sleep apnea , diabetes mellitus , univariate analysis , multivariate analysis , endocrinology
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.