ASSOCIATION OF SLEEP DISORDERS WITH CARDIOVASCULAR HEALTH ACROSS ETHNIC GROUPS

描述(由申请人提供)：观察到不同种族和性别的心血管疾病(CVD)结果存在很大差异，这不能通过考虑传统的和新的心血管疾病风险因素来完全解释。例如，非裔美国人的高血压、左心功能不全和心力衰竭的患病率比高加索人高得多，尽管血脂模式和冠状动脉钙水平通常显示出相对有利的分布。然而，只有有限的研究探讨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风险因素。在这项拟议的动脉粥样硬化多种族研究(MESA)的辅助研究中，我们旨在对参加MESA考试5的2500名非洲裔美国人、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监测和7天手腕活动监测，以得出睡眠呼吸暂停、质量、持续时间和时间的指数。新收集的睡眠数据将由中央阅读中心严格标准化和综合分析。通过利用MESA 10多年来纵向收集的丰富的临床、生理、拟人化和生化数据，我们将以心血管风险、亚临床心血管疾病和临床心血管疾病为结果，检验睡眠呼吸暂停指数(呼吸暂停低通气指数、夜间低氧血症)、睡眠时间与睡眠质量、慢波活动和昼夜节律安排之间的关系。最后，我们将量化睡眠障碍和模式在多大程度上解释了以前在种族和性别群体中观察到的心血管疾病的差异。通过确定睡眠障碍在少数民族心血管疾病中的作用，这些活动可能指导未来旨在减少慢性健康状况下的种族差异的干预措施。 公共卫生相关性：MESA中增加睡眠客观测量的提议将填补这一独特队列中风险因素数据的一个重要空白，并使睡眠障碍在动脉粥样硬化和心血管疾病发病机制中的作用得到更好的定义，从而为可能改善心血管疾病健康差异的重要干预研究铺平道路。

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. PUBLIC HEALTH RELEVANCE: The proposed addition of objective measurements of sleep to MESA will fill an important gap in risk factor data in this unique cohort and allow the role of sleep disorders in atherosclerosis and CVD pathogenesis to be better defined, thus paving the way for important intervention studies that may improve health disparities in CVD.