Arterial stiffness alteration and obstructive sleep apnea in an elderly cohort free of cardiovascular event history: the PROOF cohort study
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Several studies suggest in middle-aged subjects a relationship between arterial stiffness, a cardiovascular risk marker, and moderate to severe obstructive sleep apnea (OSA). No extensive data are present in older subjects. This study explores this association in a sample of healthy older subjects suffering OSA.
A total of 101 volunteers aged 75.3 ± 0.7 years were examined at the hospital sleep center. Each subject was assessed for medical history, body mass index and 24-h blood pressure measures, biological blood samples, and home polygraphy in 2002–2003 (P2) as well as in 2009–2010 (P4). Arterial stiffness was also assessed using carotid-femoral and carotid-radial pulse wave velocity (cfPWV and crPWV) during P4 examination.
The total group consisted of 59 women and 42 men with a mean apnea-hypopnea index (AHI) of 17.8 ± 12.1 and a mean oxygen desaturation index (ODI) of 9.8 ± 8.9. No-OSA (AHI < 15) represented 50% of the sample, and severe cases (AHI > 30) 17%. No significant differences had been founded between men and women for blood pressure, cfPWV, and crPWV. Considering the severity of the AHI, no significant differences between groups were present for PWV and blood pressure values. No difference for PWV was present for subjects with and without hypertension. No correlation was found between PWV value and AHI and ODI values at P2 or between P2 and P4 visits. cfPWV was higher in patients demonstrating incident hypertension during the follow-up.
In this sample of older subjects, PWV is not affected by AHI and ODI but was associated with incident hypertension. These results may suggest potential protective and adaptive mechanisms in older sleep apnea patients.
KeywordsObstructive sleep apnea Elderly Arterial stiffness Hypertension
body mass index
continuous positive airway pressure
high-density lipoprotein cholesterol
low-density lipoprotein cholesterol
oxygen desaturation index
obstructive sleep apnea
clinical visits of the cohort between 2002 and 2003
clinical visits of the cohort between 2009 and 2010
pulse wave velocity
carotid-femoral pulse wave velocity
carotid-radial pulse wave velocity
The authors of this study would like to thank all the study participants and Delphine Maudoux for her help in data acquisition as well as Arnauld Garcin.
French Minister of Health provided financial support in the form of PHRC 1998 and 2001 funding (funding of salaries and clinical research devices). The sponsor had no role in the design or conduct of this research.
Compliance with ethical standards
The University Hospital and the local Ethics Committee (CCPRB Rhone-Alpes Loire) approved the PROOF as well as the SYNAPSE Study. The National Committee for Information and Liberty (CNIL) gave also at this time consent for data collection. All subjects gave their written consent prior to participation in the study.
Conflicts of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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