[PP.34.02] ENDOTHELIAL FUNCTION IN MIDDLE-AGED MALE PATIENTS WITH ARTERIAL HYPERTENSION AND ADDITIONAL CONFOUNDING FACTORS: OBESITY AND OBSTRUCTIVE SLEEP APNEA SYNDROME

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Abstract

Objective:

Arterial hypertension (AH) plays pivotal role in progression of endothelial dysfunction. Obesity and obstructive sleep apnea syndrome (OSAS) are two conditions also known to decrease endothelial function. The aim of this study was to explore differences in endothelial function in patients with AH with concomitant obesity and with or without OSAS.

Design and method:

In our study we enrolled male patients with AH and 10 healthy volunteers (group 1). Patients were divided into 3 groups: group 2 patients solely with AH (n = 17) (mean age 32 (28,39–35,61), BP 147,47 (145–149,94)/ 92,53 (87,72–97,34), BMI 27,06 (23,88–30,24)), group 3 (n = 15) patients with AH and obesity (mean age 36,67 (31,49–41,85), BP 149,2 (145,31–153,09)/ 89,27 (84,49–94,04), BMI 34,84 (32,68–37)), without OSAS (AHI 4,1 (3,58–4,62)) and group 4 (n = 20) patients with AH, obesity and severe OSAS (mean age 35,8 (33,01–38,59), BP 149,1 (144,5–153,7)/ 89,5 (85,01–93,99), BMI 35,71 (33,74–37,67), AHI 59,3 (48,66–69,93)). All groups were matched in terms of age, BP and BMI (for group 3 and group 4).Cut-off values for detection of vasomotor endothelial dysfunction were: delta PWV < 5,1 (by VaSera), index occlusion amplitude (by Angioscan) < 2,0, the phase shift between the channels before and after occlusion (by Angioscan) < 10,0.

Results:

FMD% (flow-mediated vasodilation) was lower in all groups in comparison with control group, though we didn’t show statistically significant differences between groups 2, 3 and 4.

Results:

With delta PWV% were observed just the tendency for decrease.

Results:

Index occlusion amplitude was lowest in the group 4, but significant difference was only in comparison with group 2.

Results:

The phase shift between the channels before and after occlusion was lower in groups 3 and 4 in comparison with group 1; and in group 4 was lower vs group 2.

Conclusions:

In our study we didn’t obtain additional deterioration of endothelial function in patients with AH, obesity and severe OSAS in comparison with patients with AH and obesity. In terms of microvascular endothelial dysfunction the presence of severe OSAS led to additional impairment in comparison with patients solely with AH. Results could be limited to the number of enrolled patients.

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