Long-Term Effects of Cpap Therapy for Suppressing Carotid Atherosclerosis in Hypertensive Patients With Obstructive Sleep Apnea Syndrome

Objective: To examine the long-term effect of CPAP on carotid artery intima-media thickness (IMT) in hypertensive patients with Obstructive Sleep Apnea Syndrome (OSA). Design and method: This study conducted over three years at a teaching hospital included 54 patients newly diagnosed with OSA who received either CPAP or conservative treatment(CT). In total, 24 patients received CPAP, while 30 received conservative treatment, with no significant differences observed in age, BMI, ESS, AHI, arousal index, or minimum SaO2. CPAP usage averaged 4.6±0.3 hours per night over the three years. Carotid IMT was assessed with B-mode Doppler ultrasound from both carotid arteries, using images of the far wall of the distal 10 mm of the common carotid arteries at baseline and after 3 years. Results: During the 3-year follow-up, there was a more significant decrease in blood pressure in the CPAP group compared to the CT group. Mean blood pressure at 36 months was 120/71 mm Hg in the CPAP group and 131/82 mm Hg in the CT group. The IMTs at 36 months were 1.13±0.31 mm (-14.5% vs. baseline, p=0.0034) and 1.27±0.36 mm (+1.1% vs. baseline, p=0.05) in the CPAP and CT groups, respectively. There was a significantly greater decrease in the CPAP group compared to the CT group (p=0.0014).