PP.18.26] EARLY VARIATIONS IN AUGMENTATION INDEX AND PULSED WAVE VELOCITY IN PATIENTS WITH OBSTRUCTIVE SLEEP APNOEA AND ARTERIAL HYPERTENSION POST CEPAP TREATMENT

Abstract

Objective: Obstructive sleep apnea (OSA) is a risk factor for hypertension and if left untreated, is associated with high cardiovascular morbidity and mortality. Continuous positive airway pressure (CPAP) is considered the therapy of choice for moderate and severe OSA. (CPAP) reduces peripheral blood pressure and arterial stiffness. Arterial stiffness is measurable and evaluated by pulse wave velocity (PWV) and augmentation index as early markers of atherosclerosis and cardiovascular (CV) risk. The aim was to assess the early effects of (CPAP) on augmentation index and pulsed wave velocity of arterial stiffness in patients with (OSA) and arterial hypertension Design and method: The patients divided into two groups: each group was thirty patients, the first group: moderate OSA with hypertension, the second group: severe OSA with hypertension. Inclusion criteria: Patients referred to the Sleep Clinic of the chest Department, because of snoring or sleepiness with confirmed moderate-to-severe OSA (apnea/hypopnea index >15/h and >30 /h) and known to have hypertension on continuous antihypertensive treatment with BP less than 140/90 mmHg. Sleep study was done to confirm the diagnosis of OSA. Ambulatory blood pressure monitoring was done to confirm the diagnosis of hypertension. Non-invasive assessment of central aortic pressure and measuring Pulse wave velocity and augmentation index. CPAP intervention with non-invasive ventilation by CPAP. Follow-up was done after 12 weeks of CPAP intervention. Results: The effective CPAP treatment after 12 weeks showed significant BP reduction, in central systolic BP (6.2 ± 1.6 mmHg, P < 0.005), diastolic BP (4.4 ± 0.7 mmHg, P < 0.001) and, brachial systolic BP (5.4 ± 1.4 mmHg, P < 0.03) and diastolic BP (4.2 ± 0.8 mmHg, P < 0.05). and achieved PWV reduction by 1.7 ± 1.2 m/sec (P < 0.005) and a significant reduction in augmentation index (the augmentation index was 24.8% ± 11.9%) and the significant reduction in augmentation index up to 6.1% (P < 0.05). Conclusions: the effective CPAP reduces both central aortic and peripheral blood pressure and improvements in arterial stiffness parameters. The effective reduction of augmentation index and arterial stiffness will prevent cardiovascular morbidity and mortality.