Cardiovascular Department, First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, 710061, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710061, China.
Cardiovascular Department, First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, 710061, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, 710061, China.
Sleep Med. 2023 Aug;108:22-28. doi: 10.1016/j.sleep.2023.06.005. Epub 2023 Jun 3.
Currently, it's unclear whether sleep-disordered breathing (SDB) and reduced lung function could synergistically increase the incidence of coronary heart disease (CHD). Furthermore, the predictive value of different lung function indices for the incidence of CHD remains unknown.
We enrolled 3749 participants from the Sleep Heart Health Study (SHHS) to conduct a retrospective study. The individuals were divided into the SDB and non-SDB subgroups according to Apnoea-Hypopnoea Index (AHI). Cox regression models were used to evaluate the association between lung function and CHD. We also conducted a ROC analysis to assess the predictive value of different lung function indices.
512 cases of CHD were identified during an average of 10.40 years of follow-up in participants without CVD at baseline. We observed that lung function was a better predictor of CHD in non-SDB participants compared with SDB participants. Reduced lung function was associated with a higher risk of CHD in participants without SDB, while the inverse association became non-significant in participants with SDB. Furthermore, the incremental contribution of lung function to CHD diminished with increasing severity of SDB.
We need to focus more on the lung function of individuals without SDB rather than those with SDB to reduce the risk of CHD.
目前,睡眠呼吸障碍(SDB)和肺功能降低是否会协同增加冠心病(CHD)的发病率尚不清楚。此外,不同肺功能指标对 CHD 发病率的预测价值仍不清楚。
我们从睡眠心脏健康研究(SHHS)中招募了 3749 名参与者进行回顾性研究。根据呼吸暂停低通气指数(AHI)将个体分为 SDB 和非 SDB 亚组。Cox 回归模型用于评估肺功能与 CHD 之间的关系。我们还进行了 ROC 分析,以评估不同肺功能指标的预测价值。
在基线时无 CVD 的参与者中,平均随访 10.40 年后,确定了 512 例 CHD。我们观察到,与 SDB 参与者相比,肺功能在非 SDB 参与者中是 CHD 的更好预测指标。与非 SDB 参与者相比,肺功能降低与 CHD 风险增加相关,而在 SDB 参与者中,这种相关性变得不显著。此外,随着 SDB 严重程度的增加,肺功能对 CHD 的增量贡献减小。
我们需要更加关注非 SDB 个体的肺功能,而不是 SDB 个体,以降低 CHD 的风险。