Ironjustic
Fri, Sep-28-07, 17:16
Continuous Positive Airway Pressure (CPAP) lowers red blood
cell count / "CPAP treatment of sleep-disordered breathing
will reduce diurnal levels of EPO" .. in case you didn't ..
know .. http://tinyurl.com/= 3x3p8q
"after four months thickness declined by nine percent, which
is remarkable since cholesterol-lowering pravastatin therapy
saw carotid intima-media thickness decline by twelve percent
after a full year. Until now, no study has demonstrated such a
direct relationship between the two."
Public release date: 28-Sep-2007 [ Print Article | E-mail
Article | Close Window ]
Contact: Keely Savoie ksavoie@thoracic.org 212-315-8620
American Thoracic Society
Treating obstructive sleep apnea, preventing heart attacks and
strokes Researchers in Brazil have found that treating
patients who suffer from obstructive sleep apnea (OSA) with
continuous positive airway pressure (CPAP) dramatically
reduces early indications of atherosclerosis in just months,
linking OSA directly to the hardening or narrowing of the
arteries. Until now, no study has demonstrated such a direct
relationship between the two.
"OSA is independently associated with increased risk of fatal
cardiovascular events that can be reversed by treatment with
CPAP," wrote Luciano Drager, M.D., of the University of S=E3o
Paulo Medical School in Brazil.
The research was published in the first issue of the American
Journal of Respiratory and Critical Care Medicine for October
of 2007, published by the American Thoracic Society.
The researchers selected 24 men with severe OSA and no other
comorbidities and randomly assigned them to receive either
CPAP therapy or no treatment. After establishing the baseline
data for each subject, they then tracked several indicators of
pre-clinical atherosclerosis, including carotid intima-media
thickness (a measure of arterial plaque), pulse-wave velocity
(a measure of arterial stiffness), carotid diameter,
C-reactive protein (a marker of inflammation), and
catecholamine level (a marker of physical stress) over the
course of four months.
"[All markers] were similar across the study period in the
control group," wrote Dr. Drager. "In contrast, the group
treated with CPAP had a significant decrease in carotid
intima-media thickness, pulse- wave velocity, C-reactive
protein, and catecholamines."
While there is a known association between OSA and risk of
myocardial infarctions and strokes, the causal connection
between OSA and atherosclerosis as the principle mechanism
behind those cardiovascular events has proven difficult to
establish.
"The majority of patients with OSA share several risk factors
for atherosclerosis, including obesity, hypertension,
hypercholesterolemia, insulin resistance, and hyperglycemia,"
explained T. Douglas Bradley, M.D., and Dai Yumino, M.D., both
of the Sleep Research Laboratory at the Toronto Rehabilitation
Institute at the Centre for Sleep Medicine and Circadian
Biology at the University of Toronto, in an editorial in the
same issue of the journal.
Furthermore, while non-randomized observational trials have
suggested that the risk of adverse cardiovascular events is
lower among patients who accept treatment by CPAP than in
patients who do not accept CPAP therapy, it is possible that
this difference may be due to better overall adherence to
all prescribed treatments in patients who accept CPAP than
in those who do not, as opposed to any direct benefit of
CPAP itself.
"Whereas physiological studies suggest that OSA provides a
substrate for the development of atherosclerosis, and
epidemiological and observational studies suggest an
association between OSA and odds of having atherosclerosis,
there remains a gap between cause and effect yet to be
filled," wrote Drs. Yumino and Bradley. "Drager and colleagues
provide evidence that begins to fill that gap."
Indeed, after four months of CPAP therapy, carotid
intima-media thickness declined by nine percent, which is
remarkable in light of the fact that in a large-scale study,
patients undergoing cholesterol- lowering pravastatin therapy
saw carotid intima-media thickness decline by twelve percent
after a full year. Other indicators showed similar magnitudes
of improvement.
The researchers put forth a number of potential pathways
whereby OSA could contribute to atherosclerosis
progression, including inflammation, oxidative stress,
lymphocyte activation, and high- density lipoprotein
dysfunction. "CPAP treatment could reverse several of these
pathways," they wrote.
Still, the investigators caution that, while they are
confident in the biological validity of their results, the
rigid inclusion criteria makes it difficult to extrapolate
their results to different populations, including women,
patients with other co-morbidities and patients with mild to
moderate OSA.
###
--------------------------------------------------------------
--------------=
-----
"CPAP therapy reduces blood pressure"
Hypertension. 2006 Apr 3; : 16585412 Effects of Continuous
Positive Airway Pressure Versus Supplemental Oxygen on 24-Hour
Ambulatory Blood Pressure. [My paper] Daniel Norman , Jos=E9 S
Loredo , Richard A Nelesen , Sonia Ancoli-Israel , Paul J
Mills , Michael G Ziegler , Joel E Dimsdale Obstructive sleep
apnea (OSA) is associated with recurrent episodes of nocturnal
hypoxia and increased risk for development of systemic
hypertension. Prior studies have been limited, however, in
their ability to show reduction in blood pressure after
continuous positive airway pressure (CPAP) therapy, and the
effect of supplemental oxygen alone on blood pressure in OSA
has not been evaluated. We performed a randomized,
double-blind, placebo-controlled study comparing the effects
of 2 weeks of CPAP versus sham-CPAP versus supplemental
nocturnal oxygen on 24-hour ambulatory blood pressure in 46
patients with moderate-severe OSA. We found that 2 weeks of
CPAP therapy resulted in a significant reduction in daytime
mean arterial and diastolic blood pressure and nighttime
systolic, mean, and diastolic blood pressure (all Ps <0.05).
Although nocturnal supplemental oxygen therapy improved
oxyhemoglobin saturation, it did not affect blood pressure. We
conclude that CPAP therapy reduces both daytime and nighttime
blood pressure in patients with OSA, perhaps through
mechanisms other than improvement of nocturnal oxyhemoglobin
saturation.
Who loves ya. Tom
Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com
Man Is A Herbivore! http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING http://tinyurl.com/zk9fk
cell count / "CPAP treatment of sleep-disordered breathing
will reduce diurnal levels of EPO" .. in case you didn't ..
know .. http://tinyurl.com/= 3x3p8q
"after four months thickness declined by nine percent, which
is remarkable since cholesterol-lowering pravastatin therapy
saw carotid intima-media thickness decline by twelve percent
after a full year. Until now, no study has demonstrated such a
direct relationship between the two."
Public release date: 28-Sep-2007 [ Print Article | E-mail
Article | Close Window ]
Contact: Keely Savoie ksavoie@thoracic.org 212-315-8620
American Thoracic Society
Treating obstructive sleep apnea, preventing heart attacks and
strokes Researchers in Brazil have found that treating
patients who suffer from obstructive sleep apnea (OSA) with
continuous positive airway pressure (CPAP) dramatically
reduces early indications of atherosclerosis in just months,
linking OSA directly to the hardening or narrowing of the
arteries. Until now, no study has demonstrated such a direct
relationship between the two.
"OSA is independently associated with increased risk of fatal
cardiovascular events that can be reversed by treatment with
CPAP," wrote Luciano Drager, M.D., of the University of S=E3o
Paulo Medical School in Brazil.
The research was published in the first issue of the American
Journal of Respiratory and Critical Care Medicine for October
of 2007, published by the American Thoracic Society.
The researchers selected 24 men with severe OSA and no other
comorbidities and randomly assigned them to receive either
CPAP therapy or no treatment. After establishing the baseline
data for each subject, they then tracked several indicators of
pre-clinical atherosclerosis, including carotid intima-media
thickness (a measure of arterial plaque), pulse-wave velocity
(a measure of arterial stiffness), carotid diameter,
C-reactive protein (a marker of inflammation), and
catecholamine level (a marker of physical stress) over the
course of four months.
"[All markers] were similar across the study period in the
control group," wrote Dr. Drager. "In contrast, the group
treated with CPAP had a significant decrease in carotid
intima-media thickness, pulse- wave velocity, C-reactive
protein, and catecholamines."
While there is a known association between OSA and risk of
myocardial infarctions and strokes, the causal connection
between OSA and atherosclerosis as the principle mechanism
behind those cardiovascular events has proven difficult to
establish.
"The majority of patients with OSA share several risk factors
for atherosclerosis, including obesity, hypertension,
hypercholesterolemia, insulin resistance, and hyperglycemia,"
explained T. Douglas Bradley, M.D., and Dai Yumino, M.D., both
of the Sleep Research Laboratory at the Toronto Rehabilitation
Institute at the Centre for Sleep Medicine and Circadian
Biology at the University of Toronto, in an editorial in the
same issue of the journal.
Furthermore, while non-randomized observational trials have
suggested that the risk of adverse cardiovascular events is
lower among patients who accept treatment by CPAP than in
patients who do not accept CPAP therapy, it is possible that
this difference may be due to better overall adherence to
all prescribed treatments in patients who accept CPAP than
in those who do not, as opposed to any direct benefit of
CPAP itself.
"Whereas physiological studies suggest that OSA provides a
substrate for the development of atherosclerosis, and
epidemiological and observational studies suggest an
association between OSA and odds of having atherosclerosis,
there remains a gap between cause and effect yet to be
filled," wrote Drs. Yumino and Bradley. "Drager and colleagues
provide evidence that begins to fill that gap."
Indeed, after four months of CPAP therapy, carotid
intima-media thickness declined by nine percent, which is
remarkable in light of the fact that in a large-scale study,
patients undergoing cholesterol- lowering pravastatin therapy
saw carotid intima-media thickness decline by twelve percent
after a full year. Other indicators showed similar magnitudes
of improvement.
The researchers put forth a number of potential pathways
whereby OSA could contribute to atherosclerosis
progression, including inflammation, oxidative stress,
lymphocyte activation, and high- density lipoprotein
dysfunction. "CPAP treatment could reverse several of these
pathways," they wrote.
Still, the investigators caution that, while they are
confident in the biological validity of their results, the
rigid inclusion criteria makes it difficult to extrapolate
their results to different populations, including women,
patients with other co-morbidities and patients with mild to
moderate OSA.
###
--------------------------------------------------------------
--------------=
-----
"CPAP therapy reduces blood pressure"
Hypertension. 2006 Apr 3; : 16585412 Effects of Continuous
Positive Airway Pressure Versus Supplemental Oxygen on 24-Hour
Ambulatory Blood Pressure. [My paper] Daniel Norman , Jos=E9 S
Loredo , Richard A Nelesen , Sonia Ancoli-Israel , Paul J
Mills , Michael G Ziegler , Joel E Dimsdale Obstructive sleep
apnea (OSA) is associated with recurrent episodes of nocturnal
hypoxia and increased risk for development of systemic
hypertension. Prior studies have been limited, however, in
their ability to show reduction in blood pressure after
continuous positive airway pressure (CPAP) therapy, and the
effect of supplemental oxygen alone on blood pressure in OSA
has not been evaluated. We performed a randomized,
double-blind, placebo-controlled study comparing the effects
of 2 weeks of CPAP versus sham-CPAP versus supplemental
nocturnal oxygen on 24-hour ambulatory blood pressure in 46
patients with moderate-severe OSA. We found that 2 weeks of
CPAP therapy resulted in a significant reduction in daytime
mean arterial and diastolic blood pressure and nighttime
systolic, mean, and diastolic blood pressure (all Ps <0.05).
Although nocturnal supplemental oxygen therapy improved
oxyhemoglobin saturation, it did not affect blood pressure. We
conclude that CPAP therapy reduces both daytime and nighttime
blood pressure in patients with OSA, perhaps through
mechanisms other than improvement of nocturnal oxyhemoglobin
saturation.
Who loves ya. Tom
Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com
Man Is A Herbivore! http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING http://tinyurl.com/zk9fk