ASSOCIATION OF SLEEP DISORDERS WITH CARDIOVASCULAR HEALTH ACROSS ETHNIC GROUPS

描述（由申请人提供）：在不同种族和性别群体中观察到心血管疾病（CVD）结局的巨大差异，这不能通过考虑传统和新型CVD危险因素来完全解释。例如，非裔美国人的高血压、左心室功能障碍和心力衰竭的患病率明显高于白种人，尽管脂质模式和冠状动脉钙水平总体上表现出相对有利的分布。然而，只有有限的研究解决了睡眠障碍在影响少数民族心血管疾病中的作用，尽管有证据表明睡眠障碍对少数民族人群的影响不成比例，并且通过促炎或自主神经系统失调，作为高血压和心血管疾病的危险因素。在这项拟议的多种族动脉粥样硬化研究（MESA）的辅助研究中，我们的目标是对2500名参加MESA考试5的非裔美国人、西班牙裔美国人、亚裔美国人和高加索人进行标准化的家庭多导睡眠图和7天手腕活动图，以获得睡眠呼吸暂停、质量、持续时间和时间的指标。新收集的睡眠数据将由中央阅读中心严格规范和全面分析。通过利用MESA在过去10年中纵向收集的丰富的临床，生理，拟人和生化数据，我们将测试睡眠呼吸暂停指数（呼吸暂停低通气指数，夜间低氧血症），睡眠持续时间和质量，慢波活动和昼夜节律放置与CVD风险，亚临床CVD和临床CVD指数之间的关系。最后，我们将量化睡眠障碍和模式在多大程度上解释了之前在种族和性别群体中观察到的心血管疾病变化。通过确定少数民族心血管疾病中睡眠障碍的作用，这些活动可能指导未来针对减少慢性健康状况的种族差异的干预措施。

DESCRIPTION (provided by applicant): Large differences in cardiovascular disease (CVD) outcomes have been observed across ethnic and gender groups which are not fully explained by consideration of traditional and novel CVD risk factors. For example, African Americans have a considerably higher prevalence of hypertension, left ventricular dysfunction, and heart failure than Caucasians despite lipid patterns and coronary artery calcium levels that generally show relatively favorable distributions. However, only limited research has addressed the role of sleep disorders in influencing CVD in ethnic minorities despite evidence that sleep disorders disproportionately affect minority populations and, through pro-inflammatory or autonomic nervous system dysregulation, operate as risk factors for hypertension and CVD. In this proposed ancillary study to the Multi-Ethnic Study of Atherosclerosis (MESA), we aim to perform standardized in-home polysomnography and 7-day wrist actigraphy in 2500 African American, Hispanic, Asian American and Caucasian individuals participating in MESA Exam 5 to derive indices of sleep apnea, quality, duration and timing. Newly collected sleep data will be rigorously standardized and comprehensively analyzed by a central Reading Center. By capitalizing on the rich clinical, physiological, anthropomorphic, and biochemical data collected longitudinally by MESA over 10 years, we will test the associations between indices of sleep apnea (apnea hypopnea index, nocturnal hypoxemia), sleep duration and quality, slow wave activity, and circadian placement with the indices of CVD risk, subclinical CVD and clinical CVD as outcomes. Finally, we will quantify the extent to which sleep disorders and patterns account for previously observed variations in CVD among ethnic and sex groups. By defining the role of sleep disorders in CVD in ethnic minorities, these activities may direct future interventions directed at reducing ethnic disparities in chronic health conditions.