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Original Research: SLEEP MEDICINE |

Effect of Continuous Positive Airway Pressure Treatment on Serum Cardiovascular Risk Factors in Patients With Obstructive Sleep Apnea-Hypopnea Syndrome*

Paschalis Steiropoulos, MD; Venetia Tsara, MD; Evangelia Nena, MD; Christina Fitili, MD; Margarita Kataropoulou, MD; Marios Froudarakis, MD, FCCP; Pandora Christaki, MD, FCCP; Demosthenes Bouros, MD, FCCP
Author and Funding Information

*From the Sleep Unit (Drs. Steiropoulos, Tsara, Nena, and Christaki), Second Chest Department, and Third Immunology Laboratory (Drs. Fitili and Kataropoulou), “George Papanikolaou” General Hospital, Thessaloniki, Greece; and the Department of Pneumonology (Drs. Froudarakis and Bouros), Medical School of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.

Correspondence to: Paschalis Steiropoulos, MD, Department of Pneumonology, University Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece; e-mail: pstirop@med.duth.gr



Chest. 2007;132(3):843-851. doi:10.1378/chest.07-0074
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Background: Serum levels of circulating markers associated with cardiovascular morbidity are elevated in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). These factors are studied in patients mainly before the application of therapy with continuous positive airway pressure (CPAP), and the effects of CPAP treatment on them have not been thoroughly studied. Therefore, the aim of the study was to examine the effect of compliance to CPAP therapy on these factors.

Methods: Patients with newly diagnosed OSAHS, nonsmokers, without comorbidities or medication use, at baseline and during the follow-up period, were included. Serum cardiovascular risk factors (ie, high-sensitivity C-reactive protein [hs-CRP], homocysteine, total cholesterol, triglycerides, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol, apolipoprotein A-I [ApoA-I], and apolipoprotein B [ApoB]) were measured at baseline and 6 months after CPAP application. Patients were classified into the following three groups according to CPAP use: group 1 (n = 20), good compliance (≥ 4 h use per night); group 2 (n = 19), poor compliance (< 4 h use per night); and group 3 (n = 14), refusal of CPAP treatment.

Results: Fifty-three patients (47 male patients and 6 female patients; mean [± SD] age, 46.09 ± 10.87 years) were included in the study. In all groups, body mass index remained stable. In group 1, significant decreases in the levels of hs-CRP (p = 0.03), homocysteine (p = 0.005), total cholesterol (p = 0.021), total cholesterol/HDL-C ratio (p = 0.018), and ApoB/ApoA-I ratio (p = 0.021) was observed. The patients in group 2 showed a decrease in homocysteine levels (p = 0.021) only, while no significant changes were observed in the patients in group 3.

Conclusions: Good compliance to CPAP treatment lowers the serum levels of cardiovascular risk factors, indicating a beneficial effect on the overall cardiovascular risk.

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