Document Detail


Obstructive sleep apnea and aging effects on macrovascular and microcirculatory function.
MedLine Citation:
PMID:  20857864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 (< or = 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.
Authors:
Susie Yim-Yeh; Shilpa Rahangdale; Anh Tu Duy Nguyen; Amy S Jordan; Victor Novack; Aristidis Veves; Atul Malhotra
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Sleep     Volume:  33     ISSN:  0161-8105     ISO Abbreviation:  Sleep     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-22     Completed Date:  2010-12-23     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  7809084     Medline TA:  Sleep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1177-83     Citation Subset:  IM    
Affiliation:
Brigham and Women's Hospital, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aging / physiology*
Case-Control Studies
Cohort Studies
Endothelium, Vascular / physiopathology
Female
Humans
Laser-Doppler Flowmetry
Male
Microcirculation / physiology
Middle Aged
Obesity / complications,  physiopathology*
Sex Factors
Sleep Apnea, Obstructive / complications*,  physiopathology*
Vasodilation / physiology*
Young Adult
Grant Support
ID/Acronym/Agency:
K24 HL 093218/HL/NHLBI NIH HHS; R01 DK076937/DK/NIDDK NIH HHS; R01 HL085188/HL/NHLBI NIH HHS; R01 HL090897/HL/NHLBI NIH HHS; R01 HL73146/HL/NHLBI NIH HHS; R01-HL075678/HL/NHLBI NIH HHS; UL1 RR 025758-01/RR/NCRR NIH HHS
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