Brachial artery diameter, blood flow and flow-mediated dilation in sleep-disordered breathing

Hassan A. Chami, Michelle J. Keyes, Joseph A. Vita, Gary F. Mitchell, Martin G. Larson, Shuxia Fan, Ramachandran S. Vasan, George T. O'Connor, Emelia J. Benjamin, Daniel J. Gottlieb

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Clinic-based, case-control studies linked sleep-disordered breathing (SDB) to markers of endothelial dysfunction. We attempted to validate this association in a large community-based sample, and evaluate the relation of SDB to arterial diameter and peripheral blood flow. This community-based, cross-sectional observational study included 327 men and 355 women, aged 42-83 years, from the Framingham Heart Study site of the Sleep Heart Health Study. The polysomnographically derived apnea-hypopnea index and the hypoxemia index (percent sleep time with oxyhemoglobin saturation below 90%) were used to quantify the severity of SDB. Brachial artery ultrasound measurements included baseline diameter, percent flow-mediated dilation, and baseline and hyperemic flow velocity and volume. The baseline brachial artery diameter was significantly associated with both the apnea-hypopnea index and the hypoxemia index. The association was diminished by adjustment for body mass index, but remained significant for the apnea-hypopnea index. Age-, sex-, race- and body mass index-adjusted mean diameters were 4.32, 4.33, 4.33, 4.56, 4.53 mm for those with apnea-hypopnea index < 1.5, 1.5-4.9, 5-14.9, 15-29.9, > 30, respectively; p = 0.03. Baseline flow measures were associated with the apnea-hypopnea index but this association was non-significant after adjusting for body mass index. No significant association was observed between measures of SDB and percent flow-mediated dilation or hyperemic flow in any model. In conclusion, this study supports a moderate association of SDB and larger baseline brachial artery diameter, which may reflect SDB-induced vascular remodeling. This study does not support a link between SDB and endothelial dysfunction as measured by brachial artery flow-mediated dilation.

Original languageEnglish (US)
Pages (from-to)351-360
Number of pages10
JournalVascular Medicine
Volume14
Issue number4
DOIs
StatePublished - 2009
Externally publishedYes

Keywords

  • Epidemiology
  • Obstructive sleep apnea
  • Vascular endothelium
  • Vascular remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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