The effect of continuous positive airway pressure therapy on arterial stiffness and endothelial function in obstructive sleep apnea: a randomized controlled trial in patients without cardiovascular disease

Anne Jones*, Marjorie Vennelle, Martin Connell, Graham McKillop, David E. Newby, Neil J. Douglas, Renata L. Riha

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality which may be mediated by increased arterial stiffness and endothelial dysfunction. Continuous positive airway pressure (CPAP) therapy improves excessive daytime somnolence (EDS), but its effect on vascular function in patients without preexisting cardiovascular disease (CVD) is unclear.

Methods: Fifty-three patients with OSA defined as an apnea-hypopnea index (AHI) of >= 15 and without CVD were recruited into a double-blind, randomized, placebo-controlled, crossover trial of 12 weeks of CPAP therapy, of whom 43 participants completed the study protocol. Arterial stiffness was assessed by measuring the augmentation index (AIx) and pulse wave velocity (PWV) by applanation tonometry and cardiovascular magnetic resonance imaging to determine aortic distensibility. Endothelial function was assessed by measuring vascular reactivity after administration of salbutamol and glyceryl trinitrate.

Results: CPAP therapy lowered systolic blood pressure (SBP) (126 mmHg [standard deviation {SD}, 12] vs 129 mmHg [SD, 14]; P = .03), with a trend towards reduced AIx (15.5 [SD, 11.9] vs 16.6 [SD, 11.7]%; P = .08) but did not modify endothelial function. When subjects with (n = 24) and without (n = 19) EDS were separately examined, no effect of CPAP therapy on vascular function was seen.

Conclusions: In patients without overt CVD, CPAP therapy had a nonsignificant effect on AIx and did not modify endothelial function. (C) 2013 Elsevier B. V. All rights reserved.

Original languageEnglish
Pages (from-to)1260-1265
Number of pages6
JournalSleep medicine
Issue number12
Publication statusPublished - Dec 2013


  • Obstructive sleep apnea (OSA)
  • Cardiovascular disease
  • Continuous positive airway pressure (CPAP) therapy
  • Arterial stiffness
  • Endothelial function
  • Augmentation index
  • Pulse wave velocity
  • Aortic distensibility

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