C-reactive protein and heart rate recovery in middle-aged men with severe obstructive sleep apnea

The study aimed to evaluate whether the inflammatory marker "high-sensitivity C-reactive protein (hsCRP)" level was associated with impaired heart rate recovery at 1 min after exercise termination (HRR-1) in middle-aged patients with severe obstructive sleep apnea (OSA). Thirty middle-aged male patients (40-64 years old) with severe OSA (apnea-hypopnea index [AHI] a parts per thousand yenaEuro parts per thousand 30 h(-1)) and 30 subjects without OSA (AHI < 5 h(-1)), matched with age and body mass index (BMI), were recruited. All subjects underwent an overnight polysomnography and completed a symptom-limited maximal exercise test. Cardiopulmonary parameters included peak oxygen consumption (VO2peak) and heart rate response during and immediately after exercise. Fasting blood samples were drawn for hsCRP analysis. Patients with severe OSA had significantly higher hsCRP levels (0.18 vs. 0.07 mg/dl, P < 0.01), lower reduced HRR-1, peak heart rate, and VO2peak values than those in the controls. The hsCRP levels significantly correlated with HRR-1 in the OSA group (r = -0.69, P < 0.01) after adjustment for VO2peak (r = -0.66, P < 0.01). Furthermore, stepwise multiple regression analysis showed that HRR-1 and AHI were significant predictors of hsCRP levels in all participants (adjusted R (2) = 0.53, P < 0.01). Blunted HRR was shown in middle-aged men with severe OSA, and it was associated with high hsCRP levels significantly