title: Continuous positive airways pressure and uvulopalatopharyngoplasty improves pulmonary hypertension in patients with obstructive sleep apnoea.
abstract: OBJECTIVE
  Data are sparse regarding the prevalence of pulmonary hypertension (PH) in obstructive sleep apnoea (OSA) patients without COPD and clinically manifest cardiac diseases and the role of continuous positive airway pressure (CPAP) and Uvulopalatopharyngoplasty (UPPP) in normalizing this parameter.
  
  
  METHODS
  We studied 75 consecutive OSA patients, 55 of them men, using transthoracic echocardiography. A mild PH [pulmonary artery pressure (PAPs) 38.2 ± 6.8] was found in 25 subjects (prevalence 33%). These patients were divided into two groups: group 1A (n = 17), those treated with CPAP, and group 1B (n = 8), those who have the indication for a UPPP. We scheduled a follow-up at 3, 6 and 9 months. During follow-up, we performed echocardiography, measurement of anthropometric parameters (BMI, neck and waist-hip circumference), and of biochemical parameters (uric acid, fasting glucose, cholesterol, triglycerides) and blood pressure.
  
  
  RESULTS
  Patients with PH had a higher BMI: 32 ± 6 versus 29 ± 4 (p < 0.001) and NC: 39.8 ± 4.76 versus 37.14 ± 3.49 (p = 0.003), were predominantly men (72%) and older: 64 ± 20 versus 55 ± 16 (p = 0.025) and had a significantly higher value of uric acid: 7.91 ± 2.35 versus 6.56 ± 1.31 (p = 0.003). We found a positive correlation between PH and BMI (r = 0.456; p < 0.001) and between uric acidic and PH (r = 0.636; p < 0.001). PAPs significantly changed, from 39.8 ± 4.1 to 27.1 ± 4, to 25.2 ± 3.1 and to 22.2 ± 3 mmHg (CI 95%; 15.09-20.11; p < 0.001) in group 1A and from 39.5 ± 5.1 to 23.4 ± 3.2, to 23.0 ± 3.1 and to 21.9 ± 2.9 mmHg (CI 95%; 13.15-22.05; p < 0.001) in group 1B (difference between the groups p = 0.12).
  
  
  CONCLUSIONS
  PH was frequent in OSA patients and normalized after 6 months with both CPAP and UPPP. A similar trend was noted in diastolic blood pressure.
authors: Departments of Internal Medicine, Cardiology and Pneumology, Istituto Figlie di S. Camillo, Cremona, Italy, mmarvis@alice.it.
authors: Maurizio
authors: M
authors: Marvisi
authors: Maurizio Giuseppe
authors: MG
authors: Vento
authors: Laura
authors: L
authors: Balzarini
authors: Chiara
authors: C
authors: Mancini
authors: Chiara
authors: C
authors: Marvisi
mesh_terms: D000328:Adult; D000368:Aged; D062186:Arterial Pressure; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure; D004452:Echocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology; D010159:Palate / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D011651:Pulmonary Artery; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000628:therapy*; D014609:Uvula / Q000601:surgery; D055105:Waist Circumference