CARDIOVASCULAR RISK IN SLEEP APNEA--THE FRAMINGHAM STUDY

睡眠呼吸暂停的心血管风险——弗雷明汉研究

• 批准号: 2232090
• 负责人: GEORGE T O'CONNOR
• 金额: $ 37.92万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 1999-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2232090
• 关键词: CARDIOVASCULAR; RISK; SLEEP; APNEA; FRAMINGHAM

Sleep-disordered breathing (SDB) refers to a spectrum of respiratory disturbances during sleep which ranges from snoring unaccompanied by functional disturbances to clinically overt obstructive sleep apnea syndrome. SDB has been implicated as a risk factor for the development of hypertension, ischemic heart disease, and cerebral infarction. It remains uncertain whether the risk of vascular disease associated with SDB exists independent of other known vascular disease risk factors, and if so, by what physiologic mechanisms. The association of SDB with increased sympathetic nervous system activity, which has potentially important adverse effects on blood pressure, left ventricular mass, lipid profile, platelet function, and atherogenesis, suggests a plausible mechanism for an independent adverse effect of SDB on the risk of cardiac, cardiovascular, and cerebrovascular disease (collectively, CVD). We propose to evaluate the independent contribution of SDB to the risk of CVD, and to study the mechanisms underlying this risk by means of a prospective longitudinal cohort study. This study will be conducted in the well-characterized Offspring Cohort, and a newly recruited Minority Cohort, of the Framingham Heart Study, as part of a larger collaborative study of the cardiovascular consequences of sleep apnea. We will address the following specific aims, (1.) Determine the risk of cardiovascular and cerebrovascular disease associated with SDB, independent of other known risk factors for CVD. (2.) Assess potential interactions between SDB and other known CVD risk factors in relation to CVD risk. (3.) Examine the contribution of SDB to the development of other CVD risk factors. (4.) Identify population subgroups at greatest risk of CVD from SDB. (5.) Estimate the effect of SDB on quality of life and utilization of health care resources. (6.) Test the hypothesis that isolated REM-associated SDB is a risk factor for CVD. (7.) Test the hypothesis that SDB increases the risk of CVD by increasing the activity of the sympathetic nervous system. (8.) Test the hypothesis that level of ventilatory function, as measured by spirometry, modifies the risk of CVD associated with SDB.

睡眠呼吸障碍 (SDB) 是指一系列呼吸系统疾病 睡眠期间的干扰，包括无伴的打鼾 临床上明显的阻塞性睡眠呼吸暂停的功能障碍 综合症。 SDB被认为是发展的风险因素 高血压、缺血性心脏病、脑梗塞等。它仍然存在 不确定是否存在与 SDB 相关的血管疾病风险 独立于其他已知的血管疾病危险因素，如果是这样，则 有什么生理机制。 SDB与增加的关联 交感神经系统活动，具有潜在的重要作用 对血压、左心室质量、血脂的不良影响， 血小板功能和动脉粥样硬化的发生表明了一种可能的机制 SDB 对心脏病风险的独立不良影响， 心血管和脑血管疾病（统称为CVD）。我们 建议评估深发展对风险的独立贡献 CVD，并通过以下方法研究这种风险的机制： 前瞻性纵向队列研究。这项研究将在 特征鲜明的后代群体，以及新招募的少数群体 弗雷明汉心脏研究的队列，作为更大合作的一部分 研究睡眠呼吸暂停对心血管的影响。 我们将实现以下具体目标，(1.) 确定风险 与SDB相关的心脑血管疾病， 独立于其他已知的 CVD 危险因素。 (2.) 评估潜力 SDB 与其他已知 CVD 危险因素之间的相互作用 心血管疾病风险。 (3.) 考察深圳发展银行对发展的贡献 其他心血管疾病危险因素。 (4.) 最大程度地确定人口亚组 SDB 带来的 CVD 风险。 (5.) 估计 SDB 对生活质量的影响 和医疗保健资源的利用。 (6.) 检验孤立的 REM 相关 SDB 是一个危险因素的假设 用于CVD。 (7.) 检验 SDB 增加 CVD 风险的假设： 增加交感神经系统的活动。 (8.) 测试 假设通过肺活量测定法测量的通气功能水平， 改变与 SDB 相关的 CVD 风险。