ADVERTISEMENT
CURRENT ISSUE
AUGUST 2014
KINDLE EDITION



SEARCH JOURNAL ARCHIVES


SEARCH PUBMED


MANUSCRIPT SUBMISSIONS


SUBSCRIBE TO SLEEP

CONTINUING MEDICAL EDUCATION


ADVERTISE WITH US


ABOUT SLEEP

ABSTRACT SUPPLEMENTS


ACCEPTED PAPERS
Bookmark and Share         RSS Feed

VOLUME 33, ISSUE 09

EFFECTS OF OSA AND AGING ON MACRO AND MICROVASCULAR FUNCTIONS
Obstructive Sleep Apnea and Aging Effects on Macrovascular and Microcirculatory Function

Susie Yim-Yeh, MD1; Shilpa Rahangdale, MD1; Anh Tu Duy Nguyen, MD2; Amy S. Jordan, PhD1; Victor Novack, MD, PhD3; Aristidis Veves, MD4; Atul Malhotra, MD1

1Brigham and Women’s Hospital, Boston, MA; 2Respiratory Division, McGill University Health Center, Montreal, QC, Canada; 3Harvard Clinical Research Institute, Boston, MA; 4Beth Israel Deaconess Medical Center, Boston, MA



  Expand  Table of Contents    
Text size:  

Study Objectives: Many patients with obstructive sleep apnea (OSA) are obese, and whether obesity itself explains the increased prevalence of cardiovascular disease in OSA is unknown.
We hypothesize that OSA, independent of obesity, contributes to abnormal vascular function.
Design: Physiology study.
Setting: Academic medical centers.
Patients: Obese subjects, free of known comorbidities, were enrolled.
Measurements and Results: Vascular function was assessed with brachial artery ultrasound for flow-mediated dilation (FMD) and in skin microcirculation by laser Doppler flowmetry. Arterial stiffness was measured by arterial tonometry. Seventy-two subjects (43/72 women, 38/72 with OSA) were studied. FMD was impaired in patients with OSA, compared with control subjects (5.7% ± 3.8% vs 8.3% ± 4.1%, P = 0.005). In step-forward regression analysis inclusive of age, sex, and body mass index, age (P = 0.013) was a significant independent predictor of FMD. In a subgroup of subjects younger than 50 years of age (n = 59), however, OSA was the only independent predictor of FMD (P = 0.04), adjusted for known covariates. OSA did not significantly influence vascular function in the skin microcirculation. The augmentation index, a measure of arterial stiffness, was similar between the OSA and control groups (16.2% ± 11.4% vs 20.4% ± 10.1%, respectively, P = 0.10). In step-forward regression analysis of younger men (≤ 50 years old, 23 subjects), OSA independently predicted the augmentation index in men only (P = 0.001).
Conclusions: In obesity, both OSA and aging impair endothelial function and increase arterial stiffness. The influence of OSA on vascular function is most pronounced in young subjects. OSA, therefore, may be associated with functional impairment (“a premature aging effect”) on the endothelium and on arterial stiffness (in men), although skin microcirculatory function appears preserved.
Keywords: Sleep, lung, breathing, vascular, apnea, airway, hypoxemia

Expand  Table of Contents
ADVERTISEMENT
Classifieds View SLEEP 2011 Poster Presentations Online