女性睡眠特征与心血管健康的关联，以及种族/民族和绝经状态的差异：美国心脏协会“为女性变红”战略性重点研究网络的研究结果。
Association of sleep characteristics with cardiovascular health among women and differences by race/ethnicity and menopausal status: findings from the American Heart Association Go Red for Women Strategically Focused Research Network.
机构信息
Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, 51 Audubon Avenue, 5(th) Floor, New York, USA, 10032.
Department of Medicine, Division of Endocrinology and Institute of Human Nutrition, Columbia University Irving Medical Center, New York, USA.
出版信息
Sleep Health. 2019 Oct;5(5):501-508. doi: 10.1016/j.sleh.2019.05.005. Epub 2019 Jul 10.
BACKGROUND AND OBJECTIVE
Sleep is an emerging risk factor for cardiovascular disease (CVD) that is not currently included as a cardiovascular health (CVH) metric in the American Heart Association's Life's Simple 7 (AHA LS7). Our objective was to evaluate the association of sleep with CVH in women and examine differences by menopausal status and race/ethnicity.
METHODS
Baseline data from the Columbia University AHA Go Red for Women Strategically Focused Research Network were examined. Sleep habits were self-reported using validated questionnaires. A CVH score was computed using AHA LS7 criteria for smoking, diet, physical activity, BMI, blood pressure(BP), total cholesterol, and fasting glucose. Women received a score of 2 (ideal), 1 (intermediate), or 0 (poor) based on their level of meeting each AHA LS7 metric. Multivariable-adjusted regression models were used to evaluate associations of sleep with meeting overall and individual CVH metrics.
RESULTS
The analytical sample consisted of n = 507 women (62% minority/Hispanic, mean age:37 y). Participants with adequate sleep duration (≥7 h), good sleep quality, no insomnia nor snoring, and low risk for OSA were more likely to meet >4 of the AHA LS7 metrics (P < .01). Poorer sleep quality (β = -0.08, P = .002), higher insomnia severity (β = -0.05, P = .002), snoring (β = -0.77, P = .0001), and higher risk for OSA (β = -1.63, P < .0001) were associated with poorer CVH. Insomnia, snoring, and high OSA risk were associated with 69% to >300% higher odds of having poor CVH (P ≤ .03). Associations were stronger in post-menopausal and racial/ethnic minority women.
CONCLUSIONS
Better sleep habits were associated with more favorable CVH among women, suggesting that there may be benefit in incorporating sleep assessment into CVD risk screening.
背景与目的
睡眠是心血管疾病（CVD）的一个新出现的风险因素，但目前尚未被纳入美国心脏协会的“生活简单 7 项”（AHA LS7）中的心血管健康（CVH）指标。我们的目的是评估睡眠与女性 CVH 的相关性，并检查绝经状态和种族/民族差异的影响。
方法
研究分析了哥伦比亚大学 AHA Go Red for Women 战略性重点研究网络的基线数据。使用经过验证的问卷表报告睡眠习惯。使用 AHA LS7 标准（吸烟、饮食、身体活动、BMI、血压、总胆固醇和空腹血糖）计算 CVH 评分。女性根据其符合每个 AHA LS7 指标的程度获得 2（理想）、1（中等）或 0（差）的评分。多变量调整回归模型用于评估睡眠与总体和个别 CVH 指标的相关性。
结果
分析样本包括 507 名女性（62%为少数民族/西班牙裔，平均年龄 37 岁）。有足够睡眠时间（≥7 小时）、睡眠质量良好、无失眠或打鼾、以及 OSA 风险低的参与者更有可能符合 AHA LS7 标准中的>4 项（P<0.01）。睡眠质量较差（β=-0.08，P=0.002）、失眠严重程度较高（β=-0.05，P=0.002）、打鼾（β=-0.77，P=0.0001）和 OSA 风险较高（β=-1.63，P<0.0001）与 CVH 较差相关。失眠、打鼾和 OSA 风险高与 CVH 较差的可能性增加 69%至>300%相关（P≤0.03）。这些关联在绝经后和少数民族女性中更强。
结论
更好的睡眠习惯与女性更有利的 CVH 相关，这表明在 CVD 风险筛查中纳入睡眠评估可能会带来益处。
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