title: The association between sleep-disordered breathing and aortic stiffness in a community cohort.
abstract: Sleep-disordered breathing is associated with hypertension and cardiovascular disease. Increased aortic stiffness is one possible linking mechanism. We evaluated the association between sleep-disordered breathing and aortic stiffness in a community-based sample.
  
  
  
  Our community-based cross-sectional observational study included 381 participants from the Framingham Heart Study (55% women, mean age 58.0 S.D. = 9.4 years, 51% ethnic minorities). Polysomnographically derived apnea-hypopnea index and CT90% (cumulative % sleep time with oxyhemoglobin saturation <90%) quantified sleep-disordered breathing severity. Carotid-femoral pulse wave velocity, the gold-standard measure of aortic stiffness, was calculated using arterial applanation tonometry-derived waveforms and body surface measured transit distance. We assessed associations between sleep-disordered breathing and carotid-femoral pulse wave velocity using multivariable regression. We adjusted for age, sex, race, body mass index, diabetes, alcohol consumption, hormone replacement therapy, cholesterol/high-density lipoprotein, lipid-lowering therapy, anti-hypertensive medication, smoking, hypertension, and prevalent cardiovascular disease.
  
  
  
  After multivariable adjustment, carotid-femoral pulse wave velocity was associated with both apnea-hypopnea index (β = 0.03, 95% CI: 0.002-0.07, p= 0.04) and CT90% (β = 0.05, 95% CI: 0.005-0.1, p= 0.03). The adjusted mean carotid-femoral pulse wave velocity was 9.43 (95% CI: 9.12-9.74), 9.76 (95% CI: 9.25-10.26), and 10.15 (95% CI: 9.37-10.92) m/s, respectively, in subjects with apnea-hypopnea index <5, 5-14.9, and ≥15 events/h.
  
  
  
  In a community-based sample of middle aged and older men and women, sleep-disordered breathing was associated with increased carotid-femoral pulse wave velocity, a strong predictor of cardiovascular risk.
authors.affiliation: Department of Medicine, American University of Beirut, Beirut, Lebanon; The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA. Electronic address: hchami@aub.edu.lb.
authors.forename: Hassan A
authors.initials: HA
authors.lastname: Chami
authors.affiliation: Sections of Cardiovascular and Preventive Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.affiliation: Department of Mathematics and Statistics, Boston University, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.affiliation: Sections of Cardiovascular and Preventive Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.affiliation: Cardiovascular Engineering, Inc., Norwood, MA, USA.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Mitchell
authors.affiliation: VA Boston Healthcare System, Boston, MA, USA; Departments of Medicine and Neurology, Brigham & Women's Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Gottlieb
mesh_terms: D062186:Arterial Pressure; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D063177:Pulse Wave Analysis / Q000379:methods; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000097:blood / Q000150:complications*; D059289:Vascular Stiffness
keywords: Aortic stiffness; Epidemiology; Sleep apnea