Arterial Stiffness Associated with Sympathetic Hyperactivity in Obese Individuals with Moderate to Severe Obstructive Sleep Apnea.

IF 3.1 Q2 PERIPHERAL VASCULAR DISEASE High Blood Pressure & Cardiovascular Prevention Pub Date : 2023-07-01 DOI:10.1007/s40292-023-00592-3
Samanta Mattos, Michelle R Cunha, Márcia R S T Klein, Wille Oigman, Mario F Neves
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Abstract

Introduction: Obstructive Sleep Apnea (OSA) is a chronic disorder associated with several risk factors, and increased Body Mass Index (BMI) and waist circumference are correlated with it is severity.

Aim: To evaluate vascular function, central hemodynamics, and autonomic modulation in obese individuals with moderate and severe OSA.

Methods: Individuals of both sexes, aged 40-70 years and BMI ≥ 30 and < 40 kg/m2, were submitted to assessment of heart rate variability, endothelial function by flow-mediated dilatation, central parameters by oscillometry and carotid ultrasound. The sleep study was performed through a portable home sleep test device (WatchPAT).

Results: Patients (n = 76) were divided according to Apnea-Hypopnea Index (AHI): absent-mild group (AHI < 15 events/h, n = 30) and Moderate-Severe (MS) group (AHI ≥ 15 events/h, n = 46). The Low/High Frequency (LF/HF) ratio (0.81  ±  0.48 vs 1.39  ±  1.08 ms2, p = 0.035), Pulse Wave Velocity (PWV; 6.9  ±  0.7 vs 7.7  ±  1.6m/s, p = 0.004), vascular age (48  ±  6 vs 53  ±  9 years, p = 0.05) and mean intima-media thickness (0.59  ±  0.08 vs 0.66  ±  0.13 mm, p = 0.011) were significantly higher in the MS group. AHI was significantly correlated with PWV (r = 0.26, p = 0.024) and LF/HF ratio (r = 0.40, p < 0.001). Only in the MS group, PWV was significantly correlated with SD2/SD1 ratio (r = 0.611, p ≤ 0.001), and flow-mediated dilation with central systolic blood pressure (r = 0.364, p = 0.018), even after adjustment for age and sex.

Conclusion: In this sample of obese individuals, moderate to severe OSA was associated with sympathetic hyperactivity and evidence of accelerated vascular aging with arterial stiffness and subclinical atherosclerosis.

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中度至重度阻塞性睡眠呼吸暂停的肥胖患者动脉僵硬与交感神经亢进有关。
梗阻性睡眠呼吸暂停(OSA)是一种与多种危险因素相关的慢性疾病,其严重程度与体重指数(BMI)和腰围的增加有关。目的:评价肥胖伴中重度OSA患者的血管功能、中枢血流动力学和自主神经调节。方法:对年龄在40-70岁、BMI≥30和< 40 kg/m2的男性和女性进行心率变异性、血流调节扩张的内皮功能、振荡测量法和颈动脉超声的中枢参数评估。睡眠研究是通过便携式家庭睡眠测试设备(WatchPAT)进行的。结果:76例患者按呼吸暂停低通气指数(AHI)分为:无症状-轻度组(AHI 2, p = 0.035)、脉搏波速度(PWV;MS组(6.9±0.7 vs 7.7±1.6m/s, p = 0.004)、血管年龄(48±6 vs 53±9年,p = 0.05)、平均内膜-中膜厚度(0.59±0.08 vs 0.66±0.13 mm, p = 0.011)显著高于MS组(p = 0.004)。AHI与PWV (r = 0.26, p = 0.024)和LF/HF比值(r = 0.40, p)显著相关。结论:在该肥胖个体样本中,中度至重度OSA与交感神经过度活跃相关,并伴有血管硬化和亚临床动脉粥样硬化加速血管老化。
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来源期刊
CiteScore
5.70
自引率
3.30%
发文量
57
期刊介绍: High Blood Pressure & Cardiovascular Prevention promotes knowledge, update and discussion in the field of hypertension and cardiovascular disease prevention, by providing a regular programme of independent review articles covering key aspects of the management of hypertension and cardiovascular diseases. The journal includes:   Invited ''State of the Art'' reviews.  Expert commentaries on guidelines, major trials, technical advances.Presentation of new intervention trials design.''Pros and Cons'' or round tables on controversial issues.Statements on guidelines from hypertension and cardiovascular scientific societies.Socio-economic issues.Cost/benefit in prevention of cardiovascular diseases.Monitoring of healthcare systems.News and views from the Italian Society of Hypertension (including abstracts).All manuscripts are subject to peer review by international experts. Letters to the editor are welcomed and will be considered for publication.
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