Breathing treatment helps heart patients

The use of a breathing treatment called continuous positive airway pressure (CPAP) reduces cardiovascular disease risk factors in patients with severe obstructive sleep apnoea and metabolic syndrome, but only in those with good adherence to CPAP. Obstructive sleep apnoea (OSA) is a common problem, especially among the obese, in which patients stop breathing for short periods during sleep. It occurs when soft tissues in the back of the throat relax and temporarily block the airway. With CPAP, the patient wears a special mask that continuously blows air into the throat, preventing the tissues from collapsing. Metabolic syndrome is a grouping of risk factors that indicate a high risk of developing cardiovascular disease or diabetes. The risk factors include high triglyceride levels, high glucose (blood sugar) levels, high blood pressure, low levels of 'good' HDL cholesterol, and being overweight.Researchers from Slovakia studied 32 patients with both severe CPAP treated OSA and metabolic syndrome, of which 16 participants had acceptable adherence to CPAP and other 16 did not. Triglycerides, glucose, blood pressure and cholesterol levels were measured at baseline and after 8 weeks of therapy with CPAP. The participants who had acceptable adherence to CPAP were given the device to use for 4 hours per night.The adherent group showed significant reductions in blood pressure, total blood cholesterol levels and insulin resistance after 8 weeks of CPAP. They had also reduced the risk of cardiovascular disease significantly. In contrast, the nonadherent group showed no significant changes in these measures. The adherent group also experienced significant benefits in terms of harmful oxidative stress and system-wide inflammation, while the nonadherent group did not. It was concluded that good compliance with CPAP improves insulin sensitivity, reduces systematic inflammation, oxidative stress along with global cardiovascular disease risk in severe OSA and metabolic syndrome patients.

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