Relation of sleep-disordered breathing to carotid plaque and intima-media thickness☆
Section snippets
Study population
The aims and design of the SHHS have been reported in detail [10]. Briefly, between November 1995 and January 1998, SHHS participants were recruited from several ongoing population-based studies of cardiovascular or respiratory disease. The SHHS cohort comprised 6441 subjects who did not use continuous positive airway pressure, and were not treated with supplemental oxygen. B-mode carotid ultrasound measurements were available from a subset of 1236 SHHS subjects who were recruited from two
Results
The distributions of SDB indices were skewed to the right. The median value of the RDI was 8.7 events/h, and the interquartile range (25th percentile and 75th percentile) was 1.3–10.8 events/h. The 25th, 50th, and 75th percentiles of the hypoxemia index were 0.0%, 0.2%, and 1.6% of total sleep time, respectively; the corresponding values for the arousal index were 12.4, 16.9, and 24.1 events/h.
Table 1 presents characteristics of the participants by the presence or absence of carotid plaque and
Discussion
In this community-based sample of 985 middle-aged men and women, SDB, as assessed by the RDI, degree of nocturnal hypoxemia, and frequency of arousals, was modestly and positively associated with carotid plaques and carotid IMT in models with no covariates. However, after adjustment for CVD risk factors, we found no evidence of meaningful associations of SDB indices with carotid plaques or carotid IMT, implying confounded crude associations.
A growing body of evidence suggests that SDB is
Acknowledgments
The SHHS acknowledges the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, the Framingham Heart Study, the Cornell/Mt Sinai Worksite and Hypertension Studies, the Strong Heart Study, the Tucson Epidemiologic Study of Airways Obstructive Diseases, and the Tucson Health and Environment Study for allowing their cohort members to be part of the SHHS and for permitting data acquired by them to be used in the study. The SHHS is particularly grateful to the members of these
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This study was supported by National Heart, Lung and Blood Institute cooperative agreements U01 HL53940 (University of Washington, Seattle), U01 HL53941 (Boston University), U01 HL53938 (University of Arizona, Tucson), U01 HL53916 (University of California, Davis), U01 HL53934 (University of Minnesota, Minneapolis), U01 HL53931 (New York University, New York), U01 HL53937 and U01 HL64360 (The Johns Hopkins University, Baltimore, MD), U01 HL63463 (Case Western Reserve University, Cleveland, Ohio), and U01 HL63429 (Missouri Breaks Industries Research, Inc., Timber Lake, SD), and cooperative agreement supplement HL53938-07S1 (University of Arizona).