Sleep-disordered breathing and cardiovascular disease: Cross-sectional results of the sleep heart health study
Sleep-disordered breathing and cardiovascular disease: Cross-sectional results of the sleep heart health study
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DOI：
10.1164/ajrccm.163.1.2001008
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发表时间：
2001-01-01
影响因子：
24.7
通讯作者：
Samet, JM
中科院分区：
文献类型：
--
作者：
Shahar, E;Whitney, CW;Samet, JM
睡眠呼吸障碍与心血管生理学的急性不良影响有关，但很少有研究考察其与心血管疾病(CVD)的假设联系。我们研究了6424名自由生活的个体在家中接受夜间无人值守的多导睡眠监测的睡眠呼吸障碍和自我报告的心血管疾病之间的横断面关联。睡眠障碍呼吸通过呼吸暂停低呼吸指数(AHI)来量化，AHI是每小时睡眠中平均低呼吸次数。轻度至中度睡眠呼吸紊乱在样本中非常普遍(中位数AHI：4.4；四分位数范围：1.3至11.0)。共有1023名参与者(16%)报告了至少一种心血管疾病的表现(心肌梗死、心绞痛、冠状动脉血管重建术、心力衰竭或中风)。多变量调整后的相对危险度(95%CI)分别为0.98(0.77~1.24)、1.28(1.02~1.61)和1.42(1.13~1.78)。睡眠障碍呼吸与自我报告的心力衰竭和中风的相关性比与自我报告的冠心病的相关性更强：心力衰竭、中风和冠心病的相对优势(95%CI)分别为2.38(1.22-4.62)、1.58(1.02-2.46)和1.27(0.99-1.62)。这些发现与睡眠障碍呼吸对不同表现的心血管疾病在正常或仅轻度升高的AHI值范围内的轻度至中度影响是一致的。
Disordered breathing during sleep is associated with acute, unfavorable effects on cardiovascular physiology, but few studies have examined its postulated association with cardiovascular disease (CVD). We examined the cross-sectional association between sleep-disordered breathing and self-reported CVD in 6,424 free-living individuals who underwent overnight, unattended polysomnography at home. Sleep-disordered breathing was quantified by the apnea-hypopnea index (AHI)-the average number hypopneas per hour of sleep. Mild to moderate disordered breathing during sleep was highly prevalent in the sample (median AHI: 4.4; interquartile range: 1.3 to 11.0). A total of 1,023 participants (16%) reported at least one manifestation of CVD (myocardial infarction, angina, coronary revascularization procedure, heart failure, or stroke). The multivariable-adjusted relative odds (95% CI) of prevalent CVD for the second, third, and fourth quartiles of the AHI (versus the first) were 0.98 (0.77-1.24), 1.28 (1.02-1.61), and 1.42 (1.13-1.78), respectively. Sleep-disordered breathing was associated more strongly with self-reported heart failure and stroke than with self-reported coronary heart disease: the relative odds (95% CI) of heart failure, stroke, and coronary heart disease (upper versus lower AHI quartile) were 2.38 (1.22-4.62), 1.58 (1.02-2.46), and 1.27 (0.99-1.62), respectively. These findings are compatible with modest to moderate effects of sleep-disordered breathing on heterogeneous manifestations of CVD within a range of AHI values that are considered normal or only mildly elevated.