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Self-reported snoring and incident cardiovascular disease events: results from the Jackson Heart Study

  • David M. Rosen
  • Vaishnavi Kundel
  • Michael Rueschman
  • Robert Kaplan
  • Na Guo
  • James G. Wilson
  • Yuan-I Min
  • Susan Redline
  • Neomi ShahEmail author
Sleep Breathing Physiology and Disorders • Original Article

Abstract

Purpose

Evidence suggests that snoring is associated with increased risk for cardiovascular disease (CVD) events such as myocardial infarction and stroke. Limited data exists pertaining to this association among African Americans. We therefore examined the association between self-reported habitual snoring and incident CVD in the Jackson Heart Study (JHS), a population-based cohort study of African Americans.

Methods

Self-reported data on snoring and risk factors for CVD were collected at baseline (2000–2004). Participants were followed prospectively for the development of incident CVD. Habitual snoring was defined as present if the participants reported it as “often” or “almost always” or absent if reported as “sometimes,” “never,” or “seldom.” A CVD event included stroke, myocardial infarction, coronary revascularization procedure, or fatal CHD event. Cox proportional hazards models assessed the independent association between self-reported habitual snoring and incident CVD event adjusting for multiple covariates, including age, sex, hypertension, body mass index, diabetes, hypercholesterolemia, and smoking status.

Results

The snorer group consisted of 787 participants (mean age 52.1 years) and the nonsnorer group consisted of 3708 participants (mean age 54.9 years). Frequency of incident CVD events in the snorer group was not significantly different from the nonsnorer group. The fully adjusted hazard ratio for a CVD event in the snorer group was 1.01 (95% confidence interval [0.69, 1.47], p value of 0.96).

Conclusion

In conclusion, self-reported habitual snoring was not associated with incident CVD among this large African American cohort. Future studies providing objective data on snoring and sleep apnea may provide more information on the snoring-CVD association among African Americans.

Trial registration

Identification Number: NCT00005485

Keywords

Snoring Cardiovascular disease Stroke Coronary artery disease Sleep apnea 

Notes

Acknowledgments

Drs. Rosen, Shah, and Kaplan contributed to the study design. Na Guo and Michael Rueschman did the statistical analysis. Drs. Rosen, Shah, Redline, Min, and Michael Rueschman interpreted the data. Drs. Redline, Shah, Kundel, Min, and Rosen contributed to the review of the data analysis. Dr. Rosen was the primary author who was responsible for the writing of this manuscript. Many sections of the manuscript were further edited by Dr. Shah and Dr. Kundel after Dr. Rosen was unable to work on revisions of this manuscript due to graduation from fellowship. The authors thank the participants and data collection staff of the Jackson Heart Study.

Funding

The Jackson Heart Study (JHS) is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I/HHSN26800001), and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I and HHSN268201800012I) contracts from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute for Minority Health and Health Disparities (NIMHD). The study analysis was also supported by funding from Dr. Shah’s National Institute of Health/National Heart, Lung, and Blood Institute Research Career Development Award (5K23HL125923-03).

Compliance with ethical standards

Declaration of interests

The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services.

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • David M. Rosen
    • 1
  • Vaishnavi Kundel
    • 2
  • Michael Rueschman
    • 3
  • Robert Kaplan
    • 4
    • 5
  • Na Guo
    • 3
  • James G. Wilson
    • 6
  • Yuan-I Min
    • 7
  • Susan Redline
    • 3
  • Neomi Shah
    • 2
    • 4
    Email author
  1. 1.Division of Pulmonary and Critical Care MedicineThe Valley HospitalRidgewoodUSA
  2. 2.Division of Pulmonary, Critical Care and Sleep MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA
  3. 3.Brigham and Women’s Hospital, Division of Sleep and Circadian DisordersHarvard Medical SchoolBostonUSA
  4. 4.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineNew YorkUSA
  5. 5.Public Health Science DivisionFred Hutchinson Cancer Research CenterSeattleUSA
  6. 6.Department of PhysiologyThe University of Mississippi Medical CenterJacksonUSA
  7. 7.School of MedicineThe University of Mississippi Medical CenterJacksonUSA

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