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Prospective observation on the association of snoring with subclinical changes in carotid atherosclerosis over four years.

ABSTRACT: Although there is a growing interest in the independent effect of snoring on carotid atherosclerosis, few studies have observed the relationship between snoring and change in carotid atherosclerosis prospectively. Therefore, the present study aimed to prospectively examine the association of snoring with subclinical changes in carotid atherosclerosis during a four-year period.Participants in an ongoing prospective cohort study (n=3129) were enrolled. Subclinical changes in carotid atherosclerosis were assessed using: (i) mean and maximum intima-media thickness (IMT) on both common carotid arteries; (ii) prevalence of elevated IMT (maximum IMT > or = 1.0 mm); and (iii) presence of plaque. Measurement was performed using B-mode ultrasonogram at baseline and after two and four years. Subjects were classified into three groups, based on self-reported snoring frequency at baseline: habitual, occasional, and non-snorer.After adjustment for conventional cardiovascular risk factors and self-reported witnessed sleep apnea, the present study found significant cross-sectional differences in mean and maximum IMT between female snorers and non-snorers at baseline only. The changes in IMTs and presence of plaque over four years, however, did not differ by three groups, with different snoring frequency in both genders.Snoring did not accelerate subclinical change in carotid atherosclerosis during a four-year follow-up, although baseline difference in IMT between snorers and non-snorers was significant in women, independent of witnessed sleep apnea. Additional longer-term studies with objective assessment of snoring are needed.

SUBMITTER: Kim J

PROVIDER: S-EPMC4127330 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature

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Prospective observation on the association of snoring with subclinical changes in carotid atherosclerosis over four years.

Kim Jinyoung J Pack Allan A Maislin Greg G Lee Seung Ku SK Kim Seong Hwan SH Shin Chol C

Sleep medicine 20140418 7

<h4>Objective</h4>Although there is a growing interest in the independent effect of snoring on carotid atherosclerosis, few studies have observed the relationship between snoring and change in carotid atherosclerosis prospectively. Therefore, the present study aimed to prospectively examine the association of snoring with subclinical changes in carotid atherosclerosis during a four-year period.<h4>Methods</h4>Participants in an ongoing prospective cohort study (n=3129) were enrolled. Subclinical ...[more]

PMID: 24841110

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Project description:BACKGROUND: Cardiovascular diseases (CVD) are a major cause of death in people with AIDS. Factors contributing to atherosclerosis include traditional risk factors, antiretrovirals and inflammatory factors related to HIV infection. This study set out to compare risk factors associated with subclinical atherosclerosis in individuals under and over 40 years of age. METHODS: Case-control study with 697 HIV/AIDS individuals without HAART or who remain on their first antiretroviral regimen. Of the total, 351 individuals under 40 years and 346 over 40 years were analyzed separately. Subclinical atherosclerosis was assessed by carotid intima-media thickness, using B-mode ultrasound. Multivariate logistic regression was performed to find predictors of subclinical atherosclerosis in the entire group. Subsequent analysis excluded patients with major risk factors for CVD. Magnitudes of associations were expressed by odds ratio (OR) statistical significance, using a 95% confidence interval and p-value <0.05. RESULTS: In the <40 years group subclinical atherosclerosis was associated with male gender (OR: 2.77, 95% CI: 1.43-5.34), nonwhite race (OR: 3.01, 95% CI: 1.23-6.53), obesity (OR: 5.13, 95% CI: 1.79-14.7) and metabolic syndrome (OR: 3.30, 95% CI: 1.44-7.58). In the group ?40 years predictors of subclinical atherosclerosis were overweight and obesity (OR = 2.53, 95% CI, 0.85-7.54), current CD4 ?350 cells/mL (OR: 2.81, 95% CI: 1.22-6.47) and NNRTI use ? 5 years (OR: 2.65, 95% CI: 1.10-6.37) or PI use >5 years (OR: 1.81, 95% CI: 0.38-8.59). In the multivariate model excluding patients with major risk factors for CVD, age, male sex and nonwhite race were associated with subclinical atherosclerosis in the <40 y group, while in the ?40 y group, age, HIV viral load >10,000 copies and the use of NNRTI (OR: 7.60, 95% CI: 1.61-35.8) or PI ?5 years (OR: 3.62, 95% CI: 0.48-26.8) were associated with subclinical atherosclerosis. CONCLUSIONS: In young people the fight against obesity and metabolic syndrome is the main aim in the prevention of CVD. In individuals aged ?40 y, the prevention of obesity is also of great importance. Moreover, the effects of uncontrolled viremia and the prolonged use of HAART appear to be more harmful in the older group.

Project description:BackgroundThe potential impacts of beverage intake during the midlife on future subclinical atherosclerosis among women are unclear. The aim of this study was to evaluate the prospective associations between the intakes of eight beverage groups and subclinical carotid atherosclerosis in midlife women.MethodsData came from the Study of Women's Health Across the Nation, a multicenter, multiethnic, and prospective cohort study. A total of 1,235 midlife women had measures of subclinical carotid atherosclerosis and repeatedly beverage intake data collected using a validated food frequency questionnaire. Beverages were aggregated into eight groups, including coffee, tea, sugar-sweetened beverages, artificially sweetened beverages, fruit juices, whole milk, milk with lower fat content, and alcoholic beverages. The associations of beverage intake with common carotid artery intima-media thickness (CCA-IMT) and adventitial diameter (CCA-AD) were estimated using linear models; the associations with carotid plaque were estimated using log-binomial models.ResultsCoffee intake was associated with CCA-IMT in an inverted J-shaped pattern. After adjusting for covariates, women with >0 to <1 cup/day and 1 to <2 cups/day of coffee intake had a 0.031 mm (95% CI: 0.012, 0.051) and a 0.027 mm (95% CI: 0.005, 0.049) larger CCA-IMT, respectively, than coffee non-drinkers. Women who consumed ≥2 cups/day of coffee did not have significantly different CCA-IMT than non-drinkers. There was an inverse linear association between moderate alcoholic beverages intake and CCA-IMT (P-trend = 0.014). Whole milk intake had inverted U-shaped associations with CCA-IMT and carotid plaque. No significant associations were found between other beverage groups and subclinical atherosclerosis.ConclusionsIn midlife women, occasional coffee intake may be associated with more subclinical atherosclerosis while moderate alcoholic beverages intake may be associated with less subclinical atherosclerosis. Future work should focus on the determination of the optimal beverage intake profile for maximum cardiovascular benefits in midlife women.

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Prospective observation on the association of snoring with subclinical changes in carotid atherosclerosis over four years.

Publications

Prospective observation on the association of snoring with subclinical changes in carotid atherosclerosis over four years.

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