• Nihal Akar Bayram, Bülent Ciftci, Telat Keles, Tahir Durmaz, Sibel Turhan, Engin Bozkurt, and Yüksel Peker.
• Ataturk Education and Research Hospital, Cardiology Department, Ankara, Turkey.
• Sleep. 2009 Oct 1;32(10):1257-63.

Study ObjectivesTo evaluate endothelium-dependent flow-mediated dilation (FMD) and endothelium-independent nitroglycerin (NTG)-induced dilation of the brachial artery with Doppler ultrasound in patients with obstructive sleep apnea (OSA) and impact of six months of continuous positive airway pressure (CPAP) treatment.DesignA prospective, controlled, observational study.SettingSingle-site, clinic-based.PatientsTwenty-nine normotensive men with OSA (apnea-hypopnea index [AHI], mean +/- SD, 60.4 +/- 22.1-h), and 17 men without OSA (AHI 2.5 +/- 0.6-h).InterventionsSix months of CPAP therapy in OSA patients.Measurements And ResultsFMD was lower in patients with OSA compared with in controls (7.19 +/- 1.78% vs 10.93 +/- 2.59%; P < 0.001) while NTG-induced vasodilation was similar in both groups (13.75 +/- 1.01% vs 14.25 +/- 1.83%; n.s.). An inverse relationship was found between FMD and AHI adjusted for age and body mass index (BMI) (beta = - 0.05, P < 0.001). Following 6 months of CPAP treatment in the OSA group, FMD was increased from 7.38 +/- 2.06% to 10.45 +/- 1.68; P = 0.001) in 20 patients compliant with the device whereas the corresponding values did not change in the non-user group (7.08 +/- 1.50% vs 7.26 +/- 1.01%). No significant changes were observed regarding the NTG-induced vasodilation after CPAP compared with the baseline values.ConclusionsOur results confirm the previous reports suggesting impaired endothelium-dependent FMD in OSA, and additionally document the sustained improvement in endothelial function after 6 months of CPAP treatment in complaint patients.

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