6533b7defe1ef96bd1275bfa

RESEARCH PRODUCT

Arterial stiffness in obese CPAP-treated obstructive sleep apnea (OSA): A seven years prospective longitudinal study

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Introduction: Arterial stiffness measured by carotid-femoral pulse wave velocity (PWV) is elevated in severe OSA. A 1m/s increase in PWV is associated with a 15% increased risk of mortality. There is a paucity of data regarding long term evolution of PWV in CPAP-treated OSA. Aims: To measure PWV evolution in CPAP-treated OSA. Methods: In a prospective obese OSA cohort, we collected PWV, clinical and biological metabolic data, incident cardiovascular events and CPAP adherence at time of diagnosis and after at least 5-year follow-up. Results: 72 OSA (men: 52.8%, median age: 55.8 years and median BMI of 38.5 kg/m2) with a high prevalence of hypertension: 58.3%, Type 2 diabetes: 20.8%, hypercholesterolemia: 33.3%, current and past smoking: 59.7%, were evaluated after a median follow-up of 7.4 [5.8; 8.3] years. The mean increase in PWV was 1.5 (SD: 2.2) m/s. OSA patients with an elevation of PWV ≥2m/s (n=27; 37.5%) exhibited a significantly higher prevalence of diabetes (p = 0.04), and COPD (p = 0.004) and a greater amount of nocturnal hypoxia (time spent with SaO2 Conclusions: The rate of increase in PWV in CPAP-treated OSA is high and mainly related to pre-existing cardio-metabolic comorbidities. Adherence to CPAP does not influence the increase in PWV. In this population at high cardiovascular risk, combining therapeutic modalities by including weight loss and physical activity is crucial beyond CPAP treatment.