Weight Loss Improves Heart Risk in Patients with Obesity and Sleep Apnea

The dangers of obstructive sleep apnea (OSA) have been a focus of research lately, with recent studies emphasizing the cardiovascular risks associated with the condition, among other risks. Now, a new study found that weight loss is the single most important factor for improving cardiovascular health in obese OSA patients. Obesity and OSA seem to be closely tied, and are associated with a variety of cardiovascular risk factors such as insulin resistance, inflammation, high blood pressure and abnormal cholesterol. But how closely tied are obesity and obstructive sleep apnea?

Researchers from the Perelman School of Medicine at the University of Pennsylvania set out to determine what degree obesity and OSA contribute to the burden of cardiovascular risk factors and to quantify the reduction in these risk factors achieved by weight loss, therapy for OSA, or the combination of therapy and weight loss. Typical therapy for OSA is continuous positive airway pressure, (CPAP) a treatment mask that uses mild air pressure to keep the airways open during sleep.

This was a randomized controlled clinical trial of 181 patients with obesity, moderate to severe OSA, and high C-reactive protein (an inflammatory marker associated with heart disease) to weight loss therapy, CPAP, or a combination of weight loss therapy and CPAP for 24 weeks.

The researchers found that participants assigned to weight-loss only and those assigned to the combined interventions had reductions C-reactive protein levels (an inflammatory marker associated with heart disease), insulin resistance and triglyceride levels. Participants who only received CPAP therapy for their OSA did not have these improvements. Blood pressure improved in all three groups.

The findings indicate that “weight loss therapy should be a central component of strategies to improve the cardiovascular risk factor profile of obese patients with OSA”, according to the the researchers’ conclusions. The data also suggest that CPAP alone is not an effective therapy to reduce the burden of cardiovascular risk factors in this population. Finally, the results highlight that for obese patients, the combination of weight loss and CPAP therapy will result in larger reductions in blood pressure as compared with either therapy alone.

“The danger of obstructive sleep apnea is becoming more evident with time,” said Dr. Terry Simpson, expert weight loss surgeon in Arizona. “We see people’s lives change as they develop more energy after weight loss surgery – and the reason is they are sleeping better. Even those who have documented sleep apnea find their quality of sleep improves, energy is increased, and mental focus and clarity are better,” Simpson concluded.

Sleep apnea is a common condition seen in patients who consider bariatric surgery, and it is a condition that often is improved with these treatments. Please see our related reading: Evidence of Sleep Apnea Risk Grows and Bariatric Surgery and Sleep Apnea


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