The association between sleep-disordered breathing and aortic stiffness in a community cohort

Hassan A. Chami, Ramachandran S. Vasan, Martin G. Larson, Emelia J. Benjamin, Gary F. Mitchell, Daniel J. Gottlieb

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objective: Sleep-disordered breathing is associated with hypertension and cardiovascular disease. Increased aortic stiffness is one possible linking mechanism. We evaluated the association between sleep-disordered breathing and aortic stiffness in a community-based sample. Methods: Our community-based cross-sectional observational study included 381 participants from the Framingham Heart Study (55% women, mean age 58.0 S.D. = 9.4 years, 51% ethnic minorities). Polysomnographically derived apnea-hypopnea index and CT90% (cumulative % sleep time with oxyhemoglobin saturation <90%) quantified sleep-disordered breathing severity. Carotid-femoral pulse wave velocity, the gold-standard measure of aortic stiffness, was calculated using arterial applanation tonometry-derived waveforms and body surface measured transit distance. We assessed associations between sleep-disordered breathing and carotid-femoral pulse wave velocity using multivariable regression. We adjusted for age, sex, race, body mass index, diabetes, alcohol consumption, hormone replacement therapy, cholesterol/high-density lipoprotein, lipid-lowering therapy, anti-hypertensive medication, smoking, hypertension, and prevalent cardiovascular disease. Results: After multivariable adjustment, carotid-femoral pulse wave velocity was associated with both apnea-hypopnea index (β = 0.03, 95% CI: 0.002-0.07, p = 0.04) and CT90% (β = 0.05, 95% CI: 0.005-0.1, p = 0.03). The adjusted mean carotid-femoral pulse wave velocity was 9.43 (95% CI: 9.12-9.74), 9.76 (95% CI: 9.25-10.26), and 10.15 (95% CI: 9.37-10.92) m/s, respectively, in subjects with apnea-hypopnea index <5, 5-14.9, and ≥15 events/h. Conclusions: In a community-based sample of middle aged and older men and women, sleep-disordered breathing was associated with increased carotid-femoral pulse wave velocity, a strong predictor of cardiovascular risk.

Original languageEnglish (US)
Pages (from-to)69-74
Number of pages6
JournalSleep Medicine
Volume19
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

Keywords

  • Aortic stiffness
  • Epidemiology
  • Sleep apnea

ASJC Scopus subject areas

  • Medicine(all)

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