Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Am J Respir Crit Care Med. 2021 Feb 1;203(3):356-365. doi: 10.1164/rccm.201912-2330OC.
Sleep disorders are associated with hypertension and diabetes, which are primary risk factors for cardiovascular diseases and mortality. It is important to understand these associations in Hispanic/Latino individuals, in whom cardiovascular death is the leading cause of mortality. To investigate the prospective associations of sleep-disordered breathing (SDB) and insomnia with incident hypertension and diabetes among U.S. Hispanic/Latino people over 6 years of follow-up and to assess potential sex differences in these associations. Data from 11,623 Hispanic/Latino participants in the Hispanic Community Health Study/Study of Latinos (visit 1, 2008-2011; visit 2, 2014-2017) were analyzed using survey logistic regression models, adjusting for potential confounders. SDB (apnea-hypopnea index of 5 or more) and insomnia (Women's Health Initiative Insomnia Rating Scale of 9 or more) were measured at baseline. Incident hypertension (stage 2 or greater) and diabetes were defined according to national guidelines. In the target population, 52.6% were women, with a mean age of 41.1 ± 14.9 years at baseline. SDB was associated with 1.54 higher adjusted odds of incident hypertension (95% confidence interval [CI], 1.18-2.00) and 1.33 higher odds of incident diabetes (95% CI, 1.05-1.67) compared with no SDB. Insomnia was associated with incident hypertension (odds ratio, 1.37; 95% CI, 1.11-1.69) but not with diabetes. The association between insomnia and incident hypertension was stronger among men than among women. SDB was associated with incident hypertension and diabetes. Insomnia was associated with incident hypertension. These findings support the importance of sleep disorders as modifiable targets for disease prevention and reduction.
睡眠障碍与高血压和糖尿病有关,而高血压和糖尿病是心血管疾病和死亡的主要危险因素。了解西班牙裔/拉丁裔个体中的这些关联很重要,因为心血管疾病是导致该人群死亡的主要原因。本研究旨在探讨美国西班牙裔/拉丁裔人群中,经过 6 年的随访后,睡眠呼吸障碍(SDB)和失眠与高血压和糖尿病发病的前瞻性关联,并评估这些关联中的潜在性别差异。使用问卷调查逻辑回归模型,对来自 11623 名西班牙裔/拉丁裔参与者(第 1 次访视,2008-2011 年;第 2 次访视,2014-2017 年)的数据进行分析,调整了潜在的混杂因素。SDB(呼吸暂停低通气指数≥5)和失眠(女性健康倡议失眠严重程度量表≥9)在基线时进行测量。根据国家指南,定义新发高血压(2 期或更高级别)和糖尿病。在目标人群中,52.6%为女性,平均年龄为 41.1±14.9 岁。与无 SDB 相比,SDB 与新发高血压的调整后比值比(OR)增加 1.54(95%CI,1.18-2.00)和新发糖尿病的 OR 增加 1.33(95%CI,1.05-1.67)相关。失眠与新发高血压(OR,1.37;95%CI,1.11-1.69)相关,但与糖尿病无关。失眠与新发高血压的关联在男性中比女性中更强。SDB 与新发高血压和糖尿病相关。失眠与新发高血压相关。这些发现支持将睡眠障碍作为可改变的疾病预防和降低目标的重要性。