Promoting Global Cardiovascular Health

Fuster, Valentín; Kelly, Bridget B.; Vedanthan, Rajesh

doi:10.1161/circulationaha.110.009522

Cited by 108 publications

(73 citation statements)

References 6 publications

(5 reference statements)

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“…The number of cardiovascular deaths is projected to increase to more than 24 million by 2030, resulting in a huge disease burden. 1 Poor lifestyle and behavior are believed to be the leading causes of cardiovascular disease. 2 Sleep, which is a basic human behavior, is reported to be associated with the risk of cardiovascular disease and other health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults

Lao

Liu

Deng

et al. 2018

Journal of Clinical Sleep Medicine

205

113

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Study Objectives: There is limited information on the relationship between risk of cardiovascular disease and the joint effects of sleep quality and sleep duration, especially from large, prospective, cohort studies. This study is to prospectively investigate the joint effects of sleep quality and sleep duration on the development of coronary heart disease. Methods: This study examined 60,586 adults aged 40 years or older. A self-administered questionnaire was used to collect information on sleep quality and sleep duration as well as a wide range of potential confounders. Events of coronary heart disease were self-reported in subsequent medical examinations. Two types of Sleep Score (multiplicative and additive) were constructed to reflect the participants' sleep profiles, considering both sleep quality and sleep duration. The Cox regression model was used to estimate the hazard ratio (HR) and the 95% confidence interval (CI). Results: A total of 2,740 participants (4.5%) reported new events of coronary heart disease at follow-up. For sleep duration, participants in the group of < 6 h/d was significantly associated with an increased risk of coronary heart disease (HR: 1.13, 95% CI: 1.04-1.23). However, the association in the participants with long sleep duration (> 8 h/d) did not reach statistical significance (HR: 1.11, 95% CI: 0.98-1.26). For sleep quality, both dreamy sleep (HR: 1.21, 95% CI: 1.10-1.32) and difficult to fall asleep/use of sleeping pills or drugs (HR: 1.40, 95% CI: 1.25-1.56) were associated with an increased risk of the disease. Participants in the lowest quartile of multiplicative Sleep Score (HR: 1.31, 95% CI: 1.16-1.47) and of additive sleep score (HR: 1.31, 95% CI: 1.16-1.47) were associated with increased risk of coronary heart disease compared with those in the highest quartile. Conclusions: Both short sleep duration and poor sleep quality are associated with the risk of coronary heart disease. The association for long sleep duration does not reach statistical significance. Lower Sleep Score (poorer sleep profile) increases the risk of coronary heart disease, suggesting the importance of considering sleep duration and sleep quality together when developing strategies to improve sleep for cardiovascular disease prevention. Keywords: cohort study, coronary heart disease, sleep duration, sleep quality, sleep score Citation: Lao XQ, Liu X, Deng HB, Chan TC, Ho KF, Wang F, Vermeulen R, Tam T, Wong MC, Tse LA, Chang LY, Yeoh EK. Sleep quality, sleep duration, and the risk of coronary heart disease: a prospective cohort study with 60,586 adults.

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Section: Introductionmentioning

confidence: 99%

Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults

Lao

Liu

Deng

et al. 2018

Journal of Clinical Sleep Medicine

205

113

View full text Add to dashboard Cite

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“…51,52 Sympathetic activity is typically higher with intermittent discharge surges in REM sleep than in NREM sleep, and is further exacerbated with recurrent upper airway obstruction and hypoxemia. 53 This increased sympathetic output in REM sleep may underlie the relationship between sleep disordered breathing, insulin resistance, and glucose intolerance. 54,55 Moreover, there may be more pronounced neurohormonal perturbations and cytokine release during REM sleep caused by apnea and hypopnea, as compared to NREM sleep.…”

mentioning

confidence: 99%

Influence and Predicting Variables of Obstructive Sleep Apnea on Cardiac Function and Remodeling in Patients without Congestive Heart Failure

Chen

Liu

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objective: Obstructive sleep apnea syndrome (OSAS) has been considered to be an important predisposing factor for cardiovascular disease. This study aims to investigate the impact of OSAS on cardiac function and remodeling in patients without congestive heart failure. Methods: A total of 79 patients with sleep disordered breathing, preserved systolic function, and normal pro-brain natriuretic peptide level were enrolled. Sixty-fi ve patients were classifi ed to have moderate to severe OSAS (apnea-hypopnea index [AHI] ≥ 15/h), while the other 14 patients with mild or no OSAS (AHI < 15/h) served as control subjects. Baseline clinical and polysomnographic variables as well as tissue Doppler imaging and three-dimensional echocardiographic parameters were obtained. Results:The body mass index, neck circumference, Epworth Sleepiness Scale, desaturation index, arousal index, and snoring index were signifi cantly higher in patients with moderate to severe OSAS than those without (p < 0.05). The left atrial size, mitral A-wave velocity, and left ventricular end-diastolic volume were signifi cantly larger, while E/A ratio was lower in patients with moderate to severe OSAS than those without (p < 0.05). Notably, AHI in REM sleep was signifi cantly correlated with the aortic root size, E/A ratio, left ventricular volume, and stroke volume. In addition, the area under the receiver operator characteristic curve for AHI in REM sleep ≥ 32.3/h was 0.647 (95% CI [0.525, 0.769]) in predicting the development of left ventricular diastolic dysfunction. AHI in REM sleep ≥ 32.3/h was the only independent variant in predicting diastolic dysfunction after adjusting the variables including age, gender, hypertension, and body mass index. Conclusions: Patients with moderate to severe OSAS tend to have cardiac dysfunction revealed by echocardiography. High AHI in REM sleep is signifi cantly associated with cardiovascular remodeling and ventricular diastolic dysfunction, and may be a potential variable to predict cardiac dysfunction. Keywords: Echocardiography, sleep apnea syndrome, diastolic dysfunction, cardiovascular remodeling Citation: Chen YL; Su MC; Liu WH; Wang CC; Lin MC; Chen MC. Infl uence and predicting variables of obstructive sleep apnea on cardiac function and remodeling in patients without congestive heart failure.

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“…Cardiovascular disease and age-related chronic diseases are considered as the leading causes of death and disabilities worldwide [21]. Elevated blood pressure and lipids are important cardiovascular risk factors [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

DNA Methylation in NFATC1 Gene Promoter is Related to Longevity in Chinese Population

Li¹,

Xi²,

Zhang³

et al. 2017

Hereditary Genet

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Promoting Global Cardiovascular Health

Cited by 108 publications

References 6 publications

Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults

Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults

Influence and Predicting Variables of Obstructive Sleep Apnea on Cardiac Function and Remodeling in Patients without Congestive Heart Failure

DNA Methylation in NFATC1 Gene Promoter is Related to Longevity in Chinese Population

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