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高血压患者睡眠障碍与心血管疾病风险的关联:来自国家健康与营养调查(NHANES)的见解:一项横断面研究。

Associations between sleep-related disorders and cardiovascular disease risk in hypertensive patients: Insights from the National Health and Nutrition Examination Survey (NHANES): A cross-sectional study.

机构信息

Department of Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui City, China.

Lishui Central Hospital, Lishui City, China.

出版信息

Medicine (Baltimore). 2024 Sep 13;103(37):e39341. doi: 10.1097/MD.0000000000039341.

Abstract

Both sleep-related disorders (SRD) and hypertension (HTN) are closely related to the occurrence of cardiovascular disease (CVD); however, few studies have explored their combined effect. Based on the National Health and Nutrition Examination Survey (NHANES) database, we comprehensively analyzed the combined effect of SRD and HTN on the occurrence of CVD. The weighted multivariate logistic regression analysis was adopted to explore how SRD and HTN can affect the occurrence of CVD. Specifically, the additive interaction was evaluated by the relative excess risk due to interaction (RERI), attributable proportion (AP), and the synergy index (SI), and the multiplicative interaction was evaluated by the odds ratio (OR) along with 95% confidence interval (CI) from the product term. All the 33,383 participants from the NHANES database were divided into 2 groups, i.e., the CVD (n = 3712) and non-CVD (n = 29,671) groups. The results indicated that SRD (Model 3: OR = 1.90, 95% CI: 1.60-2.25) and HTN (Model 3: OR = 2.28, 95% CI: 1.87-2.79) were both significantly associated with an increased risk of CVD. Additionally, we observed a significant additive interaction (RERI = 0.88, 95% CI: 0.03-0.65; AP = 0.22, 95% CI: 0.01-0.21; SI = 1.15, 95% CI: 1.07-1.33) and a significant multiplicative interaction (OR = 1.07, 95% CI: 1.03-1.10) between SRD and HTN on the occurrence of CVD. While both SRD and HTN are associated with CVD occurrence, their interaction can also contribute to the development of CVD.

摘要

睡眠相关障碍 (SRD) 和高血压 (HTN) 均与心血管疾病 (CVD) 的发生密切相关;然而,很少有研究探讨它们的联合作用。基于国家健康和营养检查调查 (NHANES) 数据库,我们全面分析了 SRD 和 HTN 联合对 CVD 发生的影响。采用加权多变量逻辑回归分析探讨 SRD 和 HTN 如何影响 CVD 的发生。具体来说,通过交互超额相对风险 (RERI)、归因比例 (AP) 和协同指数 (SI) 评估相加交互作用,通过乘积项的比值比 (OR) 和 95%置信区间 (CI) 评估相乘交互作用。从 NHANES 数据库中所有 33383 名参与者中分为 2 组,即 CVD(n=3712)和非 CVD(n=29671)组。结果表明,SRD(模型 3:OR=1.90,95%CI:1.60-2.25)和 HTN(模型 3:OR=2.28,95%CI:1.87-2.79)均与 CVD 风险增加显著相关。此外,我们观察到明显的相加交互作用(RERI=0.88,95%CI:0.03-0.65;AP=0.22,95%CI:0.01-0.21;SI=1.15,95%CI:1.07-1.33)和明显的相乘交互作用(OR=1.07,95%CI:1.03-1.10)在 SRD 和 HTN 对 CVD 发生之间。虽然 SRD 和 HTN 均与 CVD 发生相关,但它们的相互作用也可能导致 CVD 的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e330/11404957/71dcb84cbf9d/medi-103-e39341-g001.jpg

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