Objective: To assess effect of antihypertensive (AHT) and CPAP- therapy on inflammatory risk factors of cardiovascular complications- CRP (C-reactive protein) and hsCRP (high-sensitivity CRP) as well as homocysteine in patients with arterial hypertension and obstructive sleep apnea. Design and method: We included 15 male middle-aged patients (41,1 ± 8,5 age) with AH (office BP 152,1 ± 6,6 /89,6 ± 10,1 mmHg), obesity (BMI 35,7 ± 4,6) and severe OSAS (AHI 58,9 ± 24,3), and otherwise healthy (in terms of chronic heart disease, diabetes mellitus, chronic kidney disease, manifested autoimmune or inflammatory disease). CRP, hs-CRP, homocysteine were assessed in the morning, fasting, 3 times: after initial diagnostics, after achievement of target BP levels (office BP 127,8 ± 8,1/ 76,5 ± 5,1 mmHg) 1–2 month of solely on AHT (ACEi and calcium channel blocker – fixed combination of perindopril + amlodipine) and after addition of CPAP-therapy (compliance > 4 h/night) for 3 month. Results: CRP levels didn’t change significantly with the therapy: at baseline 0,35 mg / dl, 0.26 mg /dl on AHT and 0.20 mg/dl - CPAP + AHT. hsCRP levels showed a tendency to decrease from baseline - 4.62 mg /l to 2.65 mg /l – on AHT and 2.21 mg /l on AHT+CPAP-therapy. Homocysteine level at baseline was 12,3 μmol/L, 1 month of AHT - 13,2 μmol/L and when CPAP- therapy was added to AHT level dropped to 8,5 μmol/L l (p < 0,05).Conclusions: In the study levels of CRP were in the range of normal values, whilst hsCRP was elevated at baseline and showed a tendency to decrease on AHT and CPAP-therapy, but did not reach statistical significance. It is planned to continue this study on a large sample of patients. Homocysteine levels, initially and on the AHT were at the boundary values and moderate hyperhomocysteinemia, but with CPAP-therapy showed a significantly decrease of its value to a safe level.
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