N.А. Krushynska, Yu.М. Sirenko. Capabilities of CPAP-therapy in correction of arterial stiffness in patients with arterial hypertension and obstructive sleep apnea

The aim – to assess capabilities of CPAP-therapy in correction of arterial stiffness in patients with arterial hypertension (AH) and obstructive sleep apnea (OSA).

Materials and methods. Seventy-one consecutive hypertensive patients with AH and OSA and twenty-four hypertensive patients without OSA (52.00±2.63) were enrolled into the study. They underwent clinical investigation, ambulatory and blood pressure monitoring and office blood pressure measurements, echocardiography, unattended somnograpy by dual-channel portable monitor device, applanation tonometry and estimation of daily sleepiness by Epworth Sleepiness Scale. Carotid-femoral (PWVcf) and carotid-radial (PWVcr) pulse wave velocity, central aortic pressure (CAP), left ventricular hypertrophy, blood pressure data and level of daily sleepiness were assessed.

Results. In subjects with OSA significantly higher PWVcf (11.91±0.57 vs 10.17±0.45 m/s without OSA, Р<0.02) was registered. After 9 months of CPAP (n=16) PWVcf has been significantly reduced compared to the initial level (from 12.71±0.63 to 10.35±0.53 m/s, Р<0.02). In OSA patients without CPAP (n=55) tendency to increased PWVcf was recognized (from 11.69±0.55 to 12.44±0.60 m/s, Р>0.2). Significant difference in CAP between subgroups without and with CPAP was found (134.45±2.99 vs 124.56±3.12 mm Hg respectively, Р<0.02). Conclusion. Arterial hypertension associated with OSA is accompanied by significantly worse indices of arterial stiffness. Only combination of antihypertensive treatment and CPAP-therapy may improve arterial elasticity, decrease office blood pressure and CAP.

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