Treatment of obstructive sleep apnoea leads to improved microvascular endothelial function in the systemic circulation

Lattimore, J. L.; Wilcox, I.; Skilton, M.; Langenfeld, M.; Celermajer, D. S.
June 2006
Thorax;Jun2006, Vol. 61 Issue 6, p491
Academic Journal
Background: Obstructive sleep apnoea (OSA) is a common and potentially reversible cause of systemic hypertension. The mechanisms whereby OSA leads to hypertension and the effects of treatment on arterial function, however, are not well established. Microvascular arterial endothelial and smooth muscle function was assessed in subjects with OSA before and after treatment with continuous positive airways pressure (CPAP). Methods: Ten subjects of mean (SE) age 49 (8) years with at least moderately severe OSA had detailed forearm vascular reactivity studies before and after 3 months of CPAP treatment. The systemic circulation was assessed by measuring brachial artery pressure, flow and resistance responses to intro-arterial infusions of acetylcholine (ACh; an endothelium dependent vasodilator), sodium nitroprusside (SNP; an endothelium independent vasodilator), L-NMMA (a nitric oxide (NO) antagonist), and L-arginine (the substrate for NO). Results: Before CPAP, ACh and SNP infusions increased forearm blood flow in a dose dependent manner (p<0.01). After CPAP, endothelium dependent dilation to ACh was significantly increased (434 (23)% of baseline after CPAP v 278 (20)% before CPAP, p<0.001 ), whereas SNP induced dilation was unchanged. Resting NO production was higher after CPAP, evidenced by a significantly greater reduction in basal flow by L-NMMA (p=0.05). L-Arginine reversed the effect of L-NMMA in all cases. Conclusion: In patients with OSA, treatment with CPAP improves baseline endothelial NO release and stimulates endothelium dependent vasorelaxation in the systemic circulation. This is a potential mechanism for improving systemic and vascular function in patients with OSA treated with CPAP.


Related Articles

  • High Blood Pressure Linked to Breathing Disorders.  // FDA Consumer;Jul/Aug2000, Vol. 34 Issue 4, p6 

    Reports on the association between sleep apnea and other breathing problems during sleep and high blood pressure. Details of a study involving people 40 years and older; How this association was determined.

  • Memory loss in a patient with a worrisome family history. Loftin, Eugin B. // Cortlandt Forum;5/25/2005, Vol. 18 Issue 5, p62 

    The article presents a case study of a patient suffering from obstructive sleep apnea (OSA). The patient's medical history included hypertension and hypercholesterolemia. The patient agreed to a sleep test. The respiratory disturbance index was 46 events per hour and continuous positive airway...

  • Obstructive sleep apnea: Don't minimize the risks. Hunt, Carl E.; Millman, Richard P. // Patient Care;Feb2003, Vol. 37 Issue 2, p36 

    Presents information on obstructive sleep apnea (OSA). Description and symptoms; Correlation of OSA and hypertension; Treatment and management. INSETS: What is sleep apnea?;Pediatric OSA syndrome.

  • Prevalence of sleep apnoea and snoring in hypertensive men: a population based study. Sjöström, C.; Lindberg, E.; Elmasry, A.; Hägg, A.; Svärdsudd, K.; Janson, C. // Thorax;Jul2002, Vol. 57 Issue 7, p602 

    Background: Several studies have reported an association between sleep disordered breathing (SDB) and hypertension (HT) but there is still a debate as to whether this is an effect of confounders. Some researchers have found an age dependent relationship between SDB and HI with higher risk at...

  • Hypertension and obstructive sleep apnoea syndrome: current perspectives. Baguet, J.-P.; Barone-Rochette, G.; Pépin, J.-L. // Journal of Human Hypertension;Jul2009, Vol. 23 Issue 7, p431 

    Obstructive sleep apnoea syndrome (OSAS), due to the collapse of the upper airways, is a common but still underestimated condition. The ‘dose–response’ type relationship between OSAS and hypertension (HT) has now been clearly proven. There are multiple mechanisms explaining...

  • CITATIONS AND CLINICIANS' NOTES: SLEEP-DISORDERED BREATHING.  // Current Medical Literature: Respiratory Medicine;2004, Vol. 18 Issue 3, p63 

    The article presents information on the characteristics of sleep-disordered breathing. In subjects with hypertension, there was a fall in blood pressure and plasma noradrenatine levels after the commencement of treatment. These results appear to demonstrate advantageous cardiovascular effects of...

  • Obstructive Sleep Apnea. Farnsworth, Monica M. // Journal of Continuing Education in Nursing;Nov/Dec2006, Vol. 37 Issue 6, p246 

    The article offers information about obstructive sleep apnea which is defined as a sleep disordered breathing characterized by breathing cessation and diminished airflow. One of the symptoms of the said disorder is neurobehavioral symptoms including impaired alertness, mood alterations, and...

  • Prospective Study of the Association between Sleep-Disordered Breathing and Hypertension. Peppard, Paul E.; Young, Terry; Palta, Mari; Skatrud, James // New England Journal of Medicine;05/11/2000, Vol. 342 Issue 19, p1378 

    Background: Sleep-disordered breathing is prevalent in the general population and has been linked to chronically elevated blood pressure in cross-sectional epidemiologic studies. We performed a prospective, population-based study of the association between objectively measured sleep-disordered...

  • Noninvasive mechanical ventilation in acute stroke: up new potential. Esquinas Rodriguez, Antonio; Zeren, Zeynep; Kirakli, Cenk // Neurological Sciences;Sep2013, Vol. 34 Issue 9, p1687 

    No abstract available.


Read the Article


Sign out of this library

Other Topics