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Eur Respir J 2007, doi:10.1183/09031936.00043306
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ORIGINAL ARTICLE |
Cardiovascular and metabolic effects of CPAP in obese men with OSA
1 Research Fellow, School of Clinical Sciences, University of Liverpool, Liverpool, UK
2 Research Nurse, School of Clinical Sciences , University of Liverpool, Liverpool, UK
3 Professor of Medicine, School of Clinical Sciences , University of Liverpool, Liverpool, UK
* To whom correspondence should be addressed. E-mail: pmacal{at}liv.ac.uk.
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Abstract |
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Obstructive sleep apnoea is associated with increased blood pressure and other features of the metabolic syndrome.The aim of this study was to determine the relative effectiveness of continuous positive airways pressure (CPAP) in modifying these outcomes.
A randomised placebo-controlled blinded crossover trial comparing cardiovascular and metabolic outcomes after 6 weeks of therapeutic and sham CPAP in 34 CPAP-naïve patients (mean BMI 36.1±7.6; mean RDI 39.7±13.8) was performed. Compared to sham CPAP mean waking systolic blood pressure fell by 6.7 mmHg and diastolic blood pressure by 4.9 mmHg (both p<0.01). There was no change in glucose, lipids, insulin resistance or the proportion of patients with metabolic syndrome. In CPAP-compliant patients the fall in blood pressure was greater and the baroreceptor sensitivity improved significantly (p<0.04) but no metabolic variable changed.
In obese Caucasians with untreated obstructive sleep apnoea CPAP can improve baroreceptor responsiveness and reduce waking blood pressure within six weeks, but this treatment period was insufficient to modify insulin resistance or change the metabolic profile. The mechanisms underlying this difference in the time course of blood pressure and metabolic response to CPAP in obstructive sleep apnoea requires further exploration.
Keywords: Baroreceptor sensitivity, blood pressure, insulin resistance, metabolic syndrome, sleep apnoea
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