Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study.
Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study.
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DOI：
10.1161/circulationaha.109.901801
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发表时间：
2010-07-27
期刊：
影响因子：
37.8
通讯作者：
Shahar E
中科院分区：
文献类型：
--
作者：
Gottlieb DJ;Yenokyan G;Newman AB;O'Connor GT;Punjabi NM;Quan SF;Redline S;Resnick HE;Tong EK;Diener-West M;Shahar E
基于临床的男性观察性研究报告称，阻塞性睡眠呼吸暂停（OSA）与冠心病发病率增加有关。本研究的目的是评估普通社区成年男性和女性样本中OSA与冠心病和心力衰竭的关系。一项前瞻性、纵向流行病学研究，对1927名男性和2495名女性进行了中位8.7年的随访，年龄≥ 40岁，在基线多导睡眠描记术时无冠心病和心力衰竭。在调整多个危险因素后，OSA仅在≤70岁的男性中是冠心病事件（心肌梗死、血运重建术或冠心病死亡）的重要预测因子（呼吸暂停低通气指数[AHI]每增加10个单位，调整后的风险比为1.10 [95%CI 1.00，1.21]），但在老年男性或任何年龄的女性中均不是。在40-70岁的男性中，AHI ≥30的人比AHI <5的人患冠心病的可能性高68%。OSA可预测男性心力衰竭事件，但不能预测女性心力衰竭事件（AHI每增加10个单位，调整后的风险比为1.13 [95%CI 1.02，1.26]）。AHI ≥30的男性比AHI <5的男性发生心力衰竭的可能性高58%。在社区居住的中年和老年男性中，OSA与心力衰竭事件风险增加相关;在该样本中，OSA与冠心病事件的相关性尚不明确。
Clinic-based observational studies in men have reported that obstructive sleep apnea (OSA) is associated with an increased incidence of coronary heart disease. The objective of this study was to assess the relation of OSA to incident coronary heart disease and heart failure in a general community sample of adult men and women. A prospective, longitudinal epidemiologic study of 1927 men and 2495 women aged ≥ 40 years and free of coronary heart disease and heart failure at the time of baseline polysomnography were followed for a median of 8.7 years. After adjustment for multiple risk factors, OSA was a significant predictor of incident coronary heart disease (myocardial infarction, revascularization procedure, or coronary heart disease death) only in men age ≤70 years (adjusted hazard ratio 1.10 [95% CI 1.00, 1.21] per 10-unit increase in apnea-hypopnea index [AHI]), but not in older men or in women of any age. Among men age 40–70 years, those with AHI ≥30 were 68% more likely to develop coronary heart disease than those with AHI <5. OSA predicted incident heart failure in men but not in women (adjusted hazard ratio 1.13 [95% CI 1.02, 1.26] per 10-unit increase in AHI). Men with AHI ≥30 were 58% more likely to develop heart failure than those with AHI <5. OSA is associated with increased risk of incident heart failure in community-dwelling middle-aged and older men; its association with incident coronary heart disease in this sample is equivocal.