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- W2337763018 abstract "Background The cardiovascular effects of positive airway pressure ( PAP ) therapy in obstructive sleep apnea ( OSA ) patients are not clear because of confounding by comorbid conditions. Methods and Results Prospective interventional study of PAP therapy and withdrawal. Apnea Hypopnea Index ( AHI ; events/hour of sleep) was determined from polysomnography. Central aortic blood pressures ( BPs ), Aortic Augmentation Index ( AAI x), and central ( PWV c‐f ) and peripheral pulse wave ( PWV c‐r ) velocities were determined by applanation tonometry. Echocardiography and brachial artery reactivity testing were performed at baseline, after 4 and 12 weeks of PAP therapy, and 1 week after PAP withdrawal. The 84 participants were mean (SD) 41.1 (7.6) years old and had 39.8 (24.5) AHI events/hour. After 4 weeks post‐ PAP initiation and sustained after 12 weeks, subjects experienced decreases in central systolic BP ( P =0.008), diastolic BP , mean BP , AAI x, and PWV c‐r , and brachial artery dilation (all P <0.001), as well as improvements in left ventricular diastolic function and systemic and pulmonary vascular resistance. In adjusted models, PAP use (hours/night) predicted reductions in diastolic BP (β=−0.65 [SE, 0.32] mm Hg/hour; P =0.045), AAI x (β=−0.53 [0.27] %/hour; P =0.049) and PWV c‐r (β=−0.13 [0.05] m·s −1 /hour; P =0.007), and improved brachial artery flow‐mediated dilation (β=0.31 [0.14] %/hour use; P =0.015). After 1 week of PAP withdrawal, brachial diameter, diastolic BP , mean BP , AAI x, and heart rate increased ( P ≤0.05). Conclusions PAP therapy reduces arterial tone and improves endothelial and diastolic function in young to middle‐aged adults. This positive effect is observed after 4 weeks and depends on hours of use, but reverts quickly with PAP withdrawal. Clinical Trial Registration URL: https://clinicaltrials.gov/ . Unique identifier: NCT 01317329." @default.
- W2337763018 created "2016-06-24" @default.
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- W2337763018 date "2016-04-03" @default.
- W2337763018 modified "2023-10-10" @default.
- W2337763018 title "Treatment of Obstructive Sleep Apnea in Young and Middle‐Aged Adults: Effects of Positive Airway Pressure and Compliance on Arterial Stiffness, Endothelial Function, and Cardiac Hemodynamics" @default.
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- W2337763018 doi "https://doi.org/10.1161/jaha.115.002930" @default.
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