ENDOTHELIAL FUNCTION IN PATIENTS WITH HYPERTENSION AND OBSTRUCTIVE SLEEP APNOE SYNDROME: PP.32.287

Abstract

Objective: Function assessment of endothelium by endothelial-dependent response of the brachial artery in hypertensive patients (pts) with obstructive sleep apnoe (OSA). Design and Methods: The study sample consisted of 45 male patients. They were divided into two groups consisted of 30 pts (1gr) with previously diagnosed moderate/severe hypertension (SBP24 = 167 ± 9; DBP24 = 111 ± 12) and of 15 pts (2gr) controls. 15 pts from 1gr had moderate/severe obstructive sleep apnoe (AHI = 47.5 ± 2.2). Continuous positive airway pressure therapy (CPAP) was administered to 7 patients for 12 weeks. The participants were matched for age, weight and had no any lipid or carbohydrate metabolism disorders. The brachial artery diameter was measured in all pts during the rest and on 60, 90 reactive hyperemia via HDI 5000 system in 2D-scan mode. The standard polysomnographic procedure via EMBLA flaga (Australia) and 24-hour blood pressure measurements via Spacelabs 90207 (USA) were performed for 30 subjects. Results: Flow-dependent vasodilatation (FDVD), measured in brahial artery in 1gr (m = 6.65 ± 3.0%) was significantly lower than in healthy controls (m = 11.6 ± 3.1%) (p < 0.001). In 15 pts from 1gr with moderate/severe OSA FDVD (m = 4.93 ± 2.42%) was also significantly lower than in corresponding controls (p < 0.001) and was lower than in hypertensive patients (n = 15) without OSA (m = 7.02 ± 2.77%, p < 0.05). After 12 weeks CPAP-therapy we have found a tendency to increasing FDVD from (m = 5.02 ± 2.14%) to (m = 5.58 ± 2.75%)(p = 0.06). Conclusions: Endothelial function is more attenuated in hypertensive patients with OSA, than in hypertensive patients without OSA. Thus, the higher risk of cardiovascular events in hypertensive patients with OSA could be explained. CPAP-therapy improves FDVD in pts with moderate/severe hypertension combination moderate/severe OSA.