American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2023
Randomized Controlled TrialIndoor Air Pollution and Impaired Cardiac Autonomic Function in Chronic Obstructive Pulmonary Disease.
Rationale: Indoor air pollution represents a modifiable risk factor for respiratory morbidity in chronic obstructive pulmonary disease (COPD). The effects of indoor air pollution, as well as the impact of interventions to improve indoor air quality, on cardiovascular morbidity in COPD remain unknown. Objectives: To determine the association between indoor particulate matter (PM) and heart rate variability (HRV), a measure of cardiac autonomic function tied to cardiovascular morbidity and mortality, as well as the impact of household air purifiers on HRV. ⋯ Participants randomized to the active air cleaner saw improvements in RMSSD (β, 25.2% [95% CI, 2.99 to 52.1]), but not SDNN (β, 2.65% [95% CI, -10.8 to 18.1]), compared with the placebo group. Conclusions: This is the first U. S. study to describe the association between household PM and cardiac autonomic function among individuals with COPD, as well as the potential cardiovascular health benefits of household air cleaners.
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Am. J. Respir. Crit. Care Med. · Mar 2023
Randomized Controlled Trial Multicenter StudyCPAP Effect on Albuminuria Progression in Patients with Obstructive Sleep Apnea and Diabetic Kidney Disease. A Randomized Clinical Trial.
Rationale: Obstructive sleep apnea (OSA) is associated with impaired glycemic control and a higher risk of vascular complications, such as diabetic kidney disease (DKD). However, the effect of apnea-hypopnea suppression on DKD progression is unclear. Objectives: To assess the effect of continuous positive airway pressure (CPAP) on the urinary albumin-to-creatinine ratio (UACR) in patients with DKD and OSA. ⋯ Conclusions: In patients with OSA and DKD, the prescription of CPAP did not result in a statistically significant reduction in albuminuria. However, good adherence to CPAP treatment in addition to usual care may result in long-term albuminuria reduction compared with usual care alone. Clinical trial registered with www.clinicaltrials.gov (NCT02816762).