Self-reported snoring and risk of cardiovascular disease among postmenopausal women (from the Women's Health Initiative)

Megan Sands, Eric B. Loucks, Bing Lu, Mary A. Carskadon, Katherine Sharkey, Marcia Stefanick, Judith Ockene, Neomi Shah, Kristen G. Hairston, Jennifer Robinson, Marian Limacher, Lauren Hale, Charles B. Eaton

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25 Citations (Scopus)

Abstract

Habitual snoring may be associated with cardiovascular disease (CVD); however, limited evidence exists among women. We investigated whether frequent snoring is a predictor of coronary heart disease (CHD) and stroke among 42,244 postmenopausal women participating in the Women's Health Initiative Observational Study. Participants provided self-reported information regarding snoring habits at baseline (1993 to 1998) and were followed up for outcomes through August 2009. Physician adjudicators confirmed CHD (defined as myocardial infarction, CHD death, revascularization procedures, or hospitalized angina) and ischemic stroke. Cox proportional hazards models were used to evaluate whether snoring frequency is a significant predictor of the adjudicated outcomes. We observed 2,401 incident cases of CHD during 437,899 person-years of follow-up. After adjusting for age and race, frequent snoring was associated with incident CHD (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.39 to 1.70) and stroke (HR 1.41, 95% CI 1.19 to 1.66), and all CVD (HR 1.46, 95% CI 1.34 to 1.60). In fully adjusted models that included CVD risk factors such as obesity, hypertension, and diabetes, frequent snoring was associated with a more modest increase in incident CHD (HR 1.14, 95% CI 1.01 to 1.28), stroke (HR 1.19, 95% CI 1.02 to 1.40), and CVD (HR 1.12, 95% CI 1.01 to 1.24). In conclusion, snoring is associated with a modest increased risk of incident CHD, stroke, and CVD after adjustment for CVD risk factors. Additional studies are needed to elucidate the mechanisms by which snoring might be associated with CVD risk factors and outcomes.

Original languageEnglish (US)
Pages (from-to)540-546
Number of pages7
JournalAmerican Journal of Cardiology
Volume111
Issue number4
DOIs
StatePublished - Feb 15 2013

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Snoring
Women's Health
Cardiovascular Diseases
Coronary Disease
Confidence Intervals
Stroke
Proportional Hazards Models
Habits
Observational Studies
Obesity
Myocardial Infarction
Hypertension
Physicians

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Self-reported snoring and risk of cardiovascular disease among postmenopausal women (from the Women's Health Initiative). / Sands, Megan; Loucks, Eric B.; Lu, Bing; Carskadon, Mary A.; Sharkey, Katherine; Stefanick, Marcia; Ockene, Judith; Shah, Neomi; Hairston, Kristen G.; Robinson, Jennifer; Limacher, Marian; Hale, Lauren; Eaton, Charles B.

In: American Journal of Cardiology, Vol. 111, No. 4, 15.02.2013, p. 540-546.

Research output: Contribution to journalArticle

Sands, M, Loucks, EB, Lu, B, Carskadon, MA, Sharkey, K, Stefanick, M, Ockene, J, Shah, N, Hairston, KG, Robinson, J, Limacher, M, Hale, L & Eaton, CB 2013, 'Self-reported snoring and risk of cardiovascular disease among postmenopausal women (from the Women's Health Initiative)', American Journal of Cardiology, vol. 111, no. 4, pp. 540-546. https://doi.org/10.1016/j.amjcard.2012.10.039
Sands, Megan ; Loucks, Eric B. ; Lu, Bing ; Carskadon, Mary A. ; Sharkey, Katherine ; Stefanick, Marcia ; Ockene, Judith ; Shah, Neomi ; Hairston, Kristen G. ; Robinson, Jennifer ; Limacher, Marian ; Hale, Lauren ; Eaton, Charles B. / Self-reported snoring and risk of cardiovascular disease among postmenopausal women (from the Women's Health Initiative). In: American Journal of Cardiology. 2013 ; Vol. 111, No. 4. pp. 540-546.
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abstract = "Habitual snoring may be associated with cardiovascular disease (CVD); however, limited evidence exists among women. We investigated whether frequent snoring is a predictor of coronary heart disease (CHD) and stroke among 42,244 postmenopausal women participating in the Women's Health Initiative Observational Study. Participants provided self-reported information regarding snoring habits at baseline (1993 to 1998) and were followed up for outcomes through August 2009. Physician adjudicators confirmed CHD (defined as myocardial infarction, CHD death, revascularization procedures, or hospitalized angina) and ischemic stroke. Cox proportional hazards models were used to evaluate whether snoring frequency is a significant predictor of the adjudicated outcomes. We observed 2,401 incident cases of CHD during 437,899 person-years of follow-up. After adjusting for age and race, frequent snoring was associated with incident CHD (hazard ratio [HR] 1.54, 95{\%} confidence interval [CI] 1.39 to 1.70) and stroke (HR 1.41, 95{\%} CI 1.19 to 1.66), and all CVD (HR 1.46, 95{\%} CI 1.34 to 1.60). In fully adjusted models that included CVD risk factors such as obesity, hypertension, and diabetes, frequent snoring was associated with a more modest increase in incident CHD (HR 1.14, 95{\%} CI 1.01 to 1.28), stroke (HR 1.19, 95{\%} CI 1.02 to 1.40), and CVD (HR 1.12, 95{\%} CI 1.01 to 1.24). In conclusion, snoring is associated with a modest increased risk of incident CHD, stroke, and CVD after adjustment for CVD risk factors. Additional studies are needed to elucidate the mechanisms by which snoring might be associated with CVD risk factors and outcomes.",
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AU - Stefanick, Marcia

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AU - Shah, Neomi

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AB - Habitual snoring may be associated with cardiovascular disease (CVD); however, limited evidence exists among women. We investigated whether frequent snoring is a predictor of coronary heart disease (CHD) and stroke among 42,244 postmenopausal women participating in the Women's Health Initiative Observational Study. Participants provided self-reported information regarding snoring habits at baseline (1993 to 1998) and were followed up for outcomes through August 2009. Physician adjudicators confirmed CHD (defined as myocardial infarction, CHD death, revascularization procedures, or hospitalized angina) and ischemic stroke. Cox proportional hazards models were used to evaluate whether snoring frequency is a significant predictor of the adjudicated outcomes. We observed 2,401 incident cases of CHD during 437,899 person-years of follow-up. After adjusting for age and race, frequent snoring was associated with incident CHD (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.39 to 1.70) and stroke (HR 1.41, 95% CI 1.19 to 1.66), and all CVD (HR 1.46, 95% CI 1.34 to 1.60). In fully adjusted models that included CVD risk factors such as obesity, hypertension, and diabetes, frequent snoring was associated with a more modest increase in incident CHD (HR 1.14, 95% CI 1.01 to 1.28), stroke (HR 1.19, 95% CI 1.02 to 1.40), and CVD (HR 1.12, 95% CI 1.01 to 1.24). In conclusion, snoring is associated with a modest increased risk of incident CHD, stroke, and CVD after adjustment for CVD risk factors. Additional studies are needed to elucidate the mechanisms by which snoring might be associated with CVD risk factors and outcomes.

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