Sleep Apnea Is Independently Associated With Peripheral Arterial Disease in the Hispanic Community Health Study/Study of Latinos

Neomi Shah, Matthew Allison, Yanping Teng, Sylvia Wassertheil-Smoller, Daniela Sotres-Alvarez, Alberto R. Ramos, Phyllis C. Zee, Michael H. Criqui, H. K. Yaggi, Linda C. Gallo, Susan Redline, Robert C. Kaplan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE—: Sleep apnea (SA) has been linked with various forms of cardiovascular disease, but little is known about its association with peripheral artery disease (PAD) measured using the ankle–brachial index. This relationship was evaluated in the Hispanic Community Health Study/Study of Latinos.

APPROACH AND RESULTS—: We studied 8367 Hispanic Community Health Study/Study of Latinos participants who were 45 to 74 years of age. Sleep symptoms were examined with the self-reported Sleep Health Questionnaire. SA was assessed using an in-home sleep study. Systolic blood pressure was measured in all extremities to compute the ankle–brachial index. PAD was defined as ankle–brachial index <0.90 in either leg. Multivariable logistic regression was used to investigate the association between moderate-to-severe SA, defined as apnea–hypopnea index ≥15, and the presence of PAD. Analyses were adjusted for covariates. The prevalence of PAD was 4.7% (n=390). The mean apnea–hypopnea index was significantly higher among adults with PAD compared with those without (11.1 versus 8.6 events/h; P=0.046). After adjusting for covariates, moderate-to-severe SA was associated with a 70% increase in the odds of PAD (odds ratio, 1.7; 95% confidence interval, 1.1–2.5; P=0.0152). This association was not modified by sex (P=0.8739). However, there was evidence that the association between moderate-to-severe SA and PAD varied by Hispanic/Latino background (P<0.01). Specifically, the odds were stronger in Mexican (adjusted odds ratio, 2.9; 95% confidence interval, 1.3–6.2) and in Puerto Rican Americans (adjusted odds ratio, 2.0; 95% confidence interval, 0.97–4.2) than in other backgrounds.

CONCLUSIONS—: Moderate-to-severe SA is associated with higher odds of PAD in Hispanic/Latino adults.

Original languageEnglish (US)
JournalArteriosclerosis, Thrombosis, and Vascular Biology
DOIs
StateAccepted/In press - Feb 5 2015

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Peripheral Arterial Disease
Sleep Apnea Syndromes
Hispanic Americans
Health
Sleep
Odds Ratio
Confidence Intervals
Blood Pressure
Leg
Cardiovascular Diseases
Extremities
Logistic Models

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Sleep Apnea Is Independently Associated With Peripheral Arterial Disease in the Hispanic Community Health Study/Study of Latinos. / Shah, Neomi; Allison, Matthew; Teng, Yanping; Wassertheil-Smoller, Sylvia; Sotres-Alvarez, Daniela; Ramos, Alberto R.; Zee, Phyllis C.; Criqui, Michael H.; Yaggi, H. K.; Gallo, Linda C.; Redline, Susan; Kaplan, Robert C.

In: Arteriosclerosis, Thrombosis, and Vascular Biology, 05.02.2015.

Research output: Contribution to journalArticle

Shah, Neomi ; Allison, Matthew ; Teng, Yanping ; Wassertheil-Smoller, Sylvia ; Sotres-Alvarez, Daniela ; Ramos, Alberto R. ; Zee, Phyllis C. ; Criqui, Michael H. ; Yaggi, H. K. ; Gallo, Linda C. ; Redline, Susan ; Kaplan, Robert C. / Sleep Apnea Is Independently Associated With Peripheral Arterial Disease in the Hispanic Community Health Study/Study of Latinos. In: Arteriosclerosis, Thrombosis, and Vascular Biology. 2015.
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abstract = "OBJECTIVE—: Sleep apnea (SA) has been linked with various forms of cardiovascular disease, but little is known about its association with peripheral artery disease (PAD) measured using the ankle–brachial index. This relationship was evaluated in the Hispanic Community Health Study/Study of Latinos.APPROACH AND RESULTS—: We studied 8367 Hispanic Community Health Study/Study of Latinos participants who were 45 to 74 years of age. Sleep symptoms were examined with the self-reported Sleep Health Questionnaire. SA was assessed using an in-home sleep study. Systolic blood pressure was measured in all extremities to compute the ankle–brachial index. PAD was defined as ankle–brachial index <0.90 in either leg. Multivariable logistic regression was used to investigate the association between moderate-to-severe SA, defined as apnea–hypopnea index ≥15, and the presence of PAD. Analyses were adjusted for covariates. The prevalence of PAD was 4.7{\%} (n=390). The mean apnea–hypopnea index was significantly higher among adults with PAD compared with those without (11.1 versus 8.6 events/h; P=0.046). After adjusting for covariates, moderate-to-severe SA was associated with a 70{\%} increase in the odds of PAD (odds ratio, 1.7; 95{\%} confidence interval, 1.1–2.5; P=0.0152). This association was not modified by sex (P=0.8739). However, there was evidence that the association between moderate-to-severe SA and PAD varied by Hispanic/Latino background (P<0.01). Specifically, the odds were stronger in Mexican (adjusted odds ratio, 2.9; 95{\%} confidence interval, 1.3–6.2) and in Puerto Rican Americans (adjusted odds ratio, 2.0; 95{\%} confidence interval, 0.97–4.2) than in other backgrounds.CONCLUSIONS—: Moderate-to-severe SA is associated with higher odds of PAD in Hispanic/Latino adults.",
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AU - Shah, Neomi

AU - Allison, Matthew

AU - Teng, Yanping

AU - Wassertheil-Smoller, Sylvia

AU - Sotres-Alvarez, Daniela

AU - Ramos, Alberto R.

AU - Zee, Phyllis C.

AU - Criqui, Michael H.

AU - Yaggi, H. K.

AU - Gallo, Linda C.

AU - Redline, Susan

AU - Kaplan, Robert C.

PY - 2015/2/5

Y1 - 2015/2/5

N2 - OBJECTIVE—: Sleep apnea (SA) has been linked with various forms of cardiovascular disease, but little is known about its association with peripheral artery disease (PAD) measured using the ankle–brachial index. This relationship was evaluated in the Hispanic Community Health Study/Study of Latinos.APPROACH AND RESULTS—: We studied 8367 Hispanic Community Health Study/Study of Latinos participants who were 45 to 74 years of age. Sleep symptoms were examined with the self-reported Sleep Health Questionnaire. SA was assessed using an in-home sleep study. Systolic blood pressure was measured in all extremities to compute the ankle–brachial index. PAD was defined as ankle–brachial index <0.90 in either leg. Multivariable logistic regression was used to investigate the association between moderate-to-severe SA, defined as apnea–hypopnea index ≥15, and the presence of PAD. Analyses were adjusted for covariates. The prevalence of PAD was 4.7% (n=390). The mean apnea–hypopnea index was significantly higher among adults with PAD compared with those without (11.1 versus 8.6 events/h; P=0.046). After adjusting for covariates, moderate-to-severe SA was associated with a 70% increase in the odds of PAD (odds ratio, 1.7; 95% confidence interval, 1.1–2.5; P=0.0152). This association was not modified by sex (P=0.8739). However, there was evidence that the association between moderate-to-severe SA and PAD varied by Hispanic/Latino background (P<0.01). Specifically, the odds were stronger in Mexican (adjusted odds ratio, 2.9; 95% confidence interval, 1.3–6.2) and in Puerto Rican Americans (adjusted odds ratio, 2.0; 95% confidence interval, 0.97–4.2) than in other backgrounds.CONCLUSIONS—: Moderate-to-severe SA is associated with higher odds of PAD in Hispanic/Latino adults.

AB - OBJECTIVE—: Sleep apnea (SA) has been linked with various forms of cardiovascular disease, but little is known about its association with peripheral artery disease (PAD) measured using the ankle–brachial index. This relationship was evaluated in the Hispanic Community Health Study/Study of Latinos.APPROACH AND RESULTS—: We studied 8367 Hispanic Community Health Study/Study of Latinos participants who were 45 to 74 years of age. Sleep symptoms were examined with the self-reported Sleep Health Questionnaire. SA was assessed using an in-home sleep study. Systolic blood pressure was measured in all extremities to compute the ankle–brachial index. PAD was defined as ankle–brachial index <0.90 in either leg. Multivariable logistic regression was used to investigate the association between moderate-to-severe SA, defined as apnea–hypopnea index ≥15, and the presence of PAD. Analyses were adjusted for covariates. The prevalence of PAD was 4.7% (n=390). The mean apnea–hypopnea index was significantly higher among adults with PAD compared with those without (11.1 versus 8.6 events/h; P=0.046). After adjusting for covariates, moderate-to-severe SA was associated with a 70% increase in the odds of PAD (odds ratio, 1.7; 95% confidence interval, 1.1–2.5; P=0.0152). This association was not modified by sex (P=0.8739). However, there was evidence that the association between moderate-to-severe SA and PAD varied by Hispanic/Latino background (P<0.01). Specifically, the odds were stronger in Mexican (adjusted odds ratio, 2.9; 95% confidence interval, 1.3–6.2) and in Puerto Rican Americans (adjusted odds ratio, 2.0; 95% confidence interval, 0.97–4.2) than in other backgrounds.CONCLUSIONS—: Moderate-to-severe SA is associated with higher odds of PAD in Hispanic/Latino adults.

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