Examining the effects of exercise on vascular function in obstructive sleep apnea

检查运动对阻塞性睡眠呼吸暂停患者血管功能的影响

• 批准号: 9171431
• 负责人: Devon Dobrosielski
• 金额: $ 44.15万
• 依托单位: TOWSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-25 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9171431
• 关键词: Acute; Address; Adult; Affect; American; Arousal; Attention; Attenuated; Behavior Therapy; Blood Pressure; Blood Vessels; Blood flow; Body Composition; Body Weight decreased; Cardiovascular Diseases; Central obesity; Clinical Trials; Coronary; Data; Diabetes Mellitus; Diet; Effectiveness; Endothelium; Event; Exercise; Exhibits; Health; Heart failure; Hour; Imaging Techniques; Individual; Life Style; Mediating; Medical; Medicine; Metabolic; Metabolic Diseases; Morbidity - disease rate; Non obese; Obesity; Obstructive Sleep Apnea; Oxyhemoglobin; Patients; Phenotype; Physical activity; Polysomnography; Public Health; Publications; Recommendation; Recurrence; Reporting; Research Design; Risk Factors; Severities; Sleep; Staging; Structure; Surgeon; Vascular Diseases; Weight Gain; abstracting; airway obstruction; arterial stiffness; base; brachial artery; burden of illness; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; clinical practice; cohort; college; design; exercise training; fitness; functional improvement; improved; lifestyle intervention; mortality; physical conditioning; prospective; treatment strategy; Acute; Address; Adult; Affect; American; Arousal; Attention; Attenuated; Behavior Therapy; Blood Pressure; Blood Vessels; Blood flow; Body Composition; Body Weight decreased; Cardiovascular Diseases; Central obesity; Clinical Trials; Coronary; Data; Diabetes Mellitus; Diet; Effectiveness; Endothelium; Event; Exercise; Exhibits; Health; Heart failure; Hour; Imaging Techniques; Individual; Life Style; Mediating; Medical; Medicine; Metabolic; Metabolic Diseases; Morbidity - disease rate; Non obese; Obesity; Obstructive Sleep Apnea; Oxyhemoglobin; Patients; Phenotype; Physical activity; Polysomnography; Public Health; Publications; Recommendation; Recurrence; Reporting; Research Design; Risk Factors; Severities; Sleep; Staging; Structure; Surgeon; Vascular Diseases; Weight Gain; abstracting; airway obstruction; arterial stiffness; base; brachial artery; burden of illness; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; clinical practice; cohort; college; design; exercise training; fitness; functional improvement; improved; lifestyle intervention; mortality; physical conditioning; prospective; treatment strategy

Abstract: Obstructive sleep apnea (OSA) is a serious medical condition that affects an estimated 15 million US adults and is characterized by repeated episodes of upper airway obstruction, recurrent arousals and episodic oxyhemoglobin desaturations during sleep. These abnormalities contribute to subclinical alterations in vascular function that increase the risk of cardiovascular disease morbidity and mortality. In contrast, exercise decreases the risk of cardiovascular events and the promotion of physical activity continues to be at the top of our national public health agenda, as seen in the publication of the 1996 report of the US Surgeon General on physical activity and health. While the exact mechanisms for this protective benefit are not entirely clear, there is good evidence that exercise confers cardioprotection through its direct impact on vascular endothelial function. The American College of Sleep Medicine recommends exercise as a behavioral treatment option for OSA. Yet, most clinical trials upon which this recommendation is based have focused on establishing the effectiveness of lifestyle change (e.g., dietary induced weight loss and increased physical activity participation) for improving OSA severity in obese individuals, whereas less attention has been given to whether OSA moderates the effects of exercise on the cardiovascular disease substrate. Our overarching hypothesis is that OSA attenuates the beneficial effect of exercise on vascular function in obese individuals suffering from untreated OSA. The aims of the study are to 1) examine parameters of vascular function in obese persons with and without OSA, 2) evaluate the effects of an acute bout of exercise on brachial artery flow mediated dilation in obese persons with and without OSA, and 3) examine the effects of 6 weeks of exercise training on vascular function among those with and without OSA. Our data will be immediately useful in clinical practice and inform how we prescribe exercise and implement lifestyle changes to reduce cardiovascular disease risk in OSA patients.

抽象的： 阻塞性睡眠呼吸暂停（OSA）是一种严重的医疗状况，影响约1500万美国成年人 其特征是上呼吸道阻塞，反复唤醒和情节的反复发作 睡眠期间的催产血红蛋白的饱和度。这些异常有助于血管的亚临床改变 增加心血管疾病发病率和死亡率的风险。相反，运动 降低了心血管事件的风险，促进体育锻炼仍在 正如1996年美国外科医生关于 体育锻炼和健康。虽然这种保护益处的确切机制尚不完全清楚，但 是良好的证据表明，运动通过其直接影响血管内皮的直接影响来赋予心脏保护 功能。美国睡眠医学学院建议运动作为行为治疗选择 OSA。然而，该建议所基于的大多数临床试验都集中在建立 生活方式改变的有效性（例如，饮食诱发的体重减轻和体育锻炼的增加） 为了提高肥胖个体的OSA严重程度，而对OSA是否的关注减少了 调节运动对心血管疾病底物的影响。我们的总体假设是 OSA减弱了运动对肥胖个体血管功能的有益作用 患有未经处理的OSA。研究的目的是1）检查血管功能的参数 有或没有OSA的肥胖者，2）评估急性运动对臂动脉的影响 有或没有OSA的肥胖者的流动介导的扩张，以及3）检查6周的影响 有或没有OSA的人的血管功能进行运动训练。我们的数据将立即有用 在临床实践中，并告知我们如何开出运动和实施生活方式的改变以减少 OSA患者的心血管疾病风险。