Effect of CPAP treatment on endothelial function, inflammatory markers, blood pressure and glucose control in patients with OSAS with emphasis on gender differences

Introduction: Research evidence suggests the presence of endothelial dysfunction and systemic inflammation in patients with obstructive sleep apnea syndrome (OSAS). The effects of CPAP on the aforementioned pathophysiologic pathways, as well as on the systemic disease that result or coexist with the OSAS remain elusive. Aim: To assess the effect of CPAP therapy on endothelial-dependent dilation, plasma levels of inflammatory markers, blood pressure and glucose control in male and female patients with OSAS. Methods: Our study group consisted of 40 patients with no prior history of cardiovascular disease, with an Apnea-Hypopnea Index (AHI) >15 who were assigned to receive CPAP treatment. Measurement of Flow Mediated Dilation (FMD), 24-hour ambulatory blood pressure (BP) and blood analysis were performed at baseline and 3 months after CPAP therapy. Results: Baseline FMD values were negatively correlated the AHI (r=-0.55, p=0.001). After 3 months of CPAP there was a significant increase in the FMD values and a significant reduction in the patients' 24hr systolic BP, diastolic BP and Pulse Pressure (PP), daytime systolic and diastolic BP, nighttime systolic BP and PP, the C-reactive protein (CRP) and HbA1c levels. When divided by gender, only male patients produced similar statistically significant results. Conclusion: Our results suggest that CPAP therapy improves the endothelial function, the blood pressure and glucose control in male patients with OSAS. Further research is warranted in order to further elucidate the impact of CPAP on the cardiovascular risk of male and female patients with OSAS.