Blood Pressure and Metabolic Changes After 3-Month CPAP Therapy in a Very Elderly Obese with Severe Obstructive Sleep Apnea: A Case Report and Review of the Literature.
Age is one of the main risk factor for the presence of obstructive sleep apnea (OSA). This syndrome is associated with hypertension, cardiovascular disease, cognitive impairment and metabolic abnormalities, such as type 2 diabetes. Continuous positive airway pressure (CPAP) represents the gold standard therapy, but its benefit is still to be determined in very elderly. We report the blood pressure and metabolic changes in a very elderly obese with severe OSA after 3-month CPAP therapy. We have evaluated a very elderly obese male affected by severe symptomatic OSA, poor controlled nocturnal hypertension and insulin resistance. After 3-month CPAP therapy, without any changes in drug therapy, we observed a normalization of circadian blood pressure (BP) pattern, an improved insulin sensitivity, together with a reduced resting energy expenditure, despite no significant change in weight. This case report shows the benefits of OSA treatment with CPAP, not only on BP profile, but also on metabolic parameters in a very elderly, a particular type of patient in which scientific evidence is still scant. Further studies are needed to better investigate the relationship between OSA, CPAP therapy and energy expenditure not only in adults but also in elderly patients.
Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS-INRCA, via della Montagnola n. 81, 60127, Ancona, Italy.|Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancona, Italy.
Francesco
F
Spannella
Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS-INRCA, via della Montagnola n. 81, 60127, Ancona, Italy.|Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancona, Italy.
Federico
F
Giulietti
Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS-INRCA, via della Montagnola n. 81, 60127, Ancona, Italy.|Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancona, Italy.
Chiara
C
Di Pentima
Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS-INRCA, via della Montagnola n. 81, 60127, Ancona, Italy.|Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancona, Italy.
Francesca Elena
FE
Lombardi
Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS-INRCA, via della Montagnola n. 81, 60127, Ancona, Italy.|Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancona, Italy.
Elisabetta
E
Borioni
Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS-INRCA, via della Montagnola n. 81, 60127, Ancona, Italy. r.sarzani@univpm.it.|Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancona, Italy. r.sarzani@univpm.it.
Riccardo
http://orcid.org/0000-0002-5159-0181
R
Sarzani
D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002940:Circadian Rhythm; D045422:Continuous Positive Airway Pressure; D004734:Energy Metabolism; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D007333:Insulin Resistance; D008297:Male; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers
Continuous positive airway pressure; Hypertension; Metabolism; Obesity; Obstructive sleep apnea; Very elderly