Jennum P, Hein H O, Suadicani P, Gyntelberg F
Glostrup Population Studies, Department of Internal Medicine C, Glostrup Hospital, Denmark.
Chest. 1995 Jul;108(1):138-42. doi: 10.1378/chest.108.1.138.
Former studies have demonstrated an association between habitual snoring and cardiovascular morbidity and mortality. Control for the influence of potential confounders has been inadequate. To further elucidate the issue, we examined the association between snoring and future risk of ischemic heart disease (IHD) while controlling for a number of major cardiovascular risk factors and potential effect modifiers. Some 2,937 men without overt cardiovascular disease, aged 54 to 74 y (mean = 63 years), were classified according to snoring habits and followed up prospectively during 6 years (1985 to 1991). Potential cardiovascular disease risk factors included in the study were as follows: smoking, alcohol consumption, physical activity, hypertension, blood pressure, body mass index (BMI) (kg x m-2), social class, and serum concentrations of selenium, cotinine, total cholesterol, high-density lipoprotein cholesterol, and triglycerides. During the 6-year follow-up period, 182 men (6.2%) had an IHD event (42 were fatal), and 274 men died from all causes (9.3%). There was no difference in the prevalence of snorers among those who had an IHD event and those who did not during the follow-up period, 49.9% vs 50.5%, respectively. Among the younger half of the cohort (54 to 63 years), the age-adjusted incidence of IHD was slightly but not significantly increased in snorers, relative risk (RR) = 1.2 (0.8 to 1.9). When adjustments were made for relevant confounders--use of tobacco, alcohol consumption, and BMI--the RR dropped to 1.0 (0.6 to 1.6). Among the older half (64 to 74 years), there was no increased risk in snorers, RR = 1.0 (0.7 to 1.6). We conclude that there was a slightly increased risk that did not reach statistical significance of IHD in snorers. After multivariate adjustment, snoring was not associated with risk of IHD in middle-aged and elderly men.
既往研究表明习惯性打鼾与心血管疾病的发病率和死亡率之间存在关联。对潜在混杂因素影响的控制并不充分。为了进一步阐明该问题,我们在控制了一些主要心血管危险因素和潜在效应修饰因素的情况下,研究了打鼾与未来缺血性心脏病(IHD)风险之间的关联。约2937名年龄在54至74岁(平均63岁)、无明显心血管疾病的男性,根据打鼾习惯进行分类,并在6年期间(1985年至1991年)进行前瞻性随访。研究中纳入的潜在心血管疾病危险因素如下:吸烟、饮酒、体力活动、高血压、血压、体重指数(BMI)(kg/m²)、社会阶层以及血清硒、可替宁、总胆固醇、高密度脂蛋白胆固醇和甘油三酯浓度。在6年随访期间,182名男性(6.2%)发生了IHD事件(42例死亡),274名男性死于各种原因(9.3%)。在随访期间发生IHD事件的人群和未发生IHD事件的人群中,打鼾者的患病率无差异,分别为49.9%和50.5%。在队列中年龄较小的一半人群(54至63岁)中,打鼾者IHD的年龄调整发病率略有增加,但未达到显著水平,相对危险度(RR)=1.2(0.8至1.9)。当对相关混杂因素(吸烟、饮酒和BMI)进行调整后,RR降至1.0(0.6至1.6)。在年龄较大的一半人群(64至74岁)中,打鼾者的风险未增加,RR = 1.0(0.7至1.6)。我们得出结论,打鼾者患IHD的风险略有增加,但未达到统计学显著性。经过多变量调整后,打鼾与中老年男性患IHD的风险无关。