High Pressures - Inflammation of the CV system?

[MrIvanDrago]

There have been a number of studies which claim to show no cardiovascular benefit from using CPAP.

This is counter-intuitive, but a new study indicates that higher pressures are causing the lung tissue to stretch, releasing a protein called Ang2, which causes inflammation of the CV system.

https://www.miragenews.com/why-doesnt-cp...se-1180708

Curious to hear thoughts on this?

[Sleeprider]

Another way to view this is, perhaps individuals that require higher pressure have higher Ang2 levels based on presumably higher stress levels from the severity of their untreated apnea. I would be interested to hear what happens with bilevel pressure, properly titrated to reduce both obstructive and airway resistance events. This typically results in lower overlal pressures than CPAP. Also, I'm sure this study does not consider the use of EPR. Since none of us have the ability to monitor Ang2, I'm left with optimizing pressures for efficacy and recognizing, bilevel pressure is probably better for more people than cpap.

[Gideon]

That article states that AGN2 numbers did not decrease a year later. Not that High CPAP pressures caused it. It stated a specific targeted study would be needed to see if CPAP usage has any effect on AGN2 levels.

I'm with SleepRider in that I want to see lower pressures used where possible, and that generally BiLevel therapy will deliver lower pressures and better efficacy.

The target should rarely be zero events. (I'm allowing for exceptional cases here)

[G. Szabo]

Could Gideon and SleepRider advise on the best course of action for a patient with mild and non-complex obstructive sleep apnea (AHI lower than 1, 6-7 cm median pressure of ACPCP, EPR=3) who wants to minimize the CPAP pressure? Would switching to a bilevel device be recommended? Or should the patient consider ResMed’s ASV therapy? 
Thank you.

[Sleeprider]

G Szabo, is this a different question related to the original post? Maybe start a new thread with some more specific background and a chart?

[G. Szabo]

Thanks for the quick reply. I will do.