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Relation of sleep-disordered breathing to carotid plaque and intima-media thickness.

TitleRelation of sleep-disordered breathing to carotid plaque and intima-media thickness.
Publication TypeJournal Article
Year of Publication2008
AuthorsWattanakit, K, Boland, L, Punjabi, NM, Shahar, E
JournalAtherosclerosis
Volume197
Issue1
Pagination125-31
Date Published2008 Mar
ISSN1879-1484
KeywordsAged, Carotid Arteries, Carotid Artery Diseases, Female, Humans, Male, Middle Aged, Odds Ratio, Risk Factors, Sleep Apnea Syndromes, Tunica Intima, Tunica Media, Ultrasonography
Abstract<p><b>BACKGROUND: </b>Sleep-disordered breathing (SDB) is associated with clinical cardiovascular disease (CVD), but its relation to subclinical atherosclerosis remains to be determined.</p><p><b>METHODS: </b>We analyzed the cross-sectional associations of SDB, measured by the respiratory disturbance index (RDI), a hypoxemia index, and an arousal index, with carotid plaque and carotid intima-media thickness (IMT), measured by ultrasound. The sample included 985 participants in the Sleep Heart Health Study (mean age-62, median RDI-8.7) with no history of coronary heart disease and stroke, of whom 396 had evidence of a carotid plaque.</p><p><b>RESULTS: </b>As compared with the first quartile of the RDI (0-1.2), the crude odds ratio for carotid plaque was 1.14, 1.27, and 1.48 for the second (1.3-4.1), third (4.2-10.7), and fourth (>10.7) quartile, respectively. After adjustment for CVD risk factors, the corresponding odds ratios were reduced (1.00, 1.04, 1.07, and 1.25). Similarly, the unadjusted mean carotid IMT increased with RDI, but adjusted means (mm) were similar (0.84, 0.85, 0.84, 0.85). Spline regression models did not show monotonicity of the dose-response functions at the right end of the RDI distribution. Neither the hypoxemia index nor the arousal index was associated with carotid plaque or carotid IMT.</p><p><b>CONCLUSION: </b>The results of this study suggest that crude, positive associations between SDB and subclinical atherosclerosis can be attributed to confounding by CVD risk factors.</p>
DOI10.1016/j.atherosclerosis.2007.02.029
Alternate JournalAtherosclerosis
PubMed ID17433330
Grant ListHL53938-07S1 / HL / NHLBI NIH HHS / United States
U01 HL53916 / HL / NHLBI NIH HHS / United States
U01 HL53931 / HL / NHLBI NIH HHS / United States
U01 HL53934 / HL / NHLBI NIH HHS / United States
U01 HL53937 / HL / NHLBI NIH HHS / United States
U01 HL53938 / HL / NHLBI NIH HHS / United States
U01 HL53940 / HL / NHLBI NIH HHS / United States
U01 HL53941 / HL / NHLBI NIH HHS / United States
U01 HL63429 / HL / NHLBI NIH HHS / United States
U01 HL63463 / HL / NHLBI NIH HHS / United States
U01 HL64360 / HL / NHLBI NIH HHS / United States