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Sleep apnea is independently associated with peripheral arterial disease in the Hispanic Community Health Study/Study of Latinos.

TitleSleep apnea is independently associated with peripheral arterial disease in the Hispanic Community Health Study/Study of Latinos.
Publication TypePublication
Year2015
AuthorsShah N, Allison M, Teng Y, Wassertheil-Smoller S, Sotres-Alvarez D, Ramos AR, Zee PC, Criqui MH, Yaggi HK, Gallo LC, Redline S, Kaplan RC
JournalArterioscler Thromb Vasc Biol
Volume35
Issue3
Pagination710-5
Date Published2015 Mar
ISSN1524-4636
KeywordsAged, ankle brachial index, Chi-Square Distribution, Comorbidity, Female, Hispanic Americans, Humans, Logistic Models, Male, Mexican Americans, Middle Aged, Multivariate Analysis, Odds Ratio, Peripheral Arterial Disease, Puerto Rico, Risk Assessment, Risk Factors, Severity of Illness Index, Sleep Apnea Syndromes, Surveys and Questionnaires, United States
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.

DOI10.1161/ATVBAHA.114.304625
Alternate JournalArterioscler Thromb Vasc Biol
PubMed ID25657310
PubMed Central IDPMC4545273
Grant ListN01 HC065234 / HC / NHLBI NIH HHS / United States
KL2 TR000461 / TR / NCATS NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
N01 HC065237 / HC / NHLBI NIH HHS / United States
N01-HC65237 / HC / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01 HC065233 / HC / NHLBI NIH HHS / United States
K24 HL132093 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
N01-HC65233 / HC / NHLBI NIH HHS / United States
N01 HC065236 / HC / NHLBI NIH HHS / United States
UL1 TR001073 / TR / NCATS NIH HHS / United States
N01-HC65234 / HC / NHLBI NIH HHS / United States
N01-HC65236 / HC / NHLBI NIH HHS / United States
N01 HC065235 / HC / NHLBI NIH HHS / United States
N01-HC65235 / HC / NHLBI NIH HHS / United States
MS#: 
0022
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
ECI: 
Manuscript Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
Manuscript Status: 
Published