Sleep-Disordered Breathing and Risk for CVD and Stroke in the Jackson Heart Study

杰克逊心脏研究中睡眠呼吸障碍与心血管疾病和中风的风险

• 批准号: 8297074
• 负责人: Susan S. Redline
• 金额: $ 76.47万
• 依托单位: UNIVERSITY OF MISSISSIPPI MED CTR
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-06-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8297074
• 关键词: Acute; Address; Affect; African American; Alcohol consumption; American; Anatomy; Anger; Anxiety; Area; Behavioral; Biochemical; Biological Markers; Blood Pressure; Cardiovascular Diseases; Central obesity; Chronic; Cohort Studies; Communities; Coronary Arteriosclerosis; Coronary heart disease; Data; Diabetes Mellitus; Discrimination; Disease Outcome; Dyslipidemias; Emotions; Ethnic Origin; European; Event; Foundations; Future; Glucose; Goals; Health; Heart; High Prevalence; Home environment; Hostility; Household; Hypertension; Impairment; Incidence; Inflammation; Inflammatory; Insulin Resistance; Interleukin-6; Intervention; Knowledge; Link; Measurement; Measures; Medial; Mediating; Mediator of activation protein; Mental Depression; Metabolic; Minor; Minority; Modeling; Monitor; Morbidity - disease rate; Neck; Not Hispanic or Latino; Obesity; Outcome; Participant; Pathway interactions; Patient Self-Report; Pattern; Physical activity; Population; Prevalence; Protocols documentation; Psychological Factors; Psychosocial Factor; Public Health; Recommendation; Reporting; Research; Research Personnel; Risk; Risk Factors; Role; Sampling; Screening procedure; Severities; Shipping; Ships; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleeplessness; Socioeconomic Status; Stress; Stroke; Symptoms; Thick; Tobacco use; Wrist; actigraphy; base; blood glucose regulation; cardiovascular disorder risk; cohort; density; diabetes risk; glucose metabolism; health disparity; indexing; intima media; low socioeconomic status; member; minority health; modifiable risk; mortality; negative emotional state; novel; prospective; psychological stressor; psychosocial; reduced alcohol use; social; stressor

DESCRIPTION (provided by applicant): Despite national initiatives to address health disparities, African Americans (AAs) suffer higher rates of cardiovascular disease (CVD), especially stroke, than European Americans (EAs). The Jackson Heart Study (JHS) was established in 2000 with the aim of generating data that would support public health recommendations for reducing CVD disparities in AAs. This landmark study has reported a higher prevalence of diabetes and uncontrolled hypertension in this entirely AA cohort compared to other U.S. mostly EA cohorts. Increased risk factor prevalence is not explained by obesity or other traditional risk factors, suggesting a potential role for additional unmeasured factors in influencing adverse cardio- metabolic outcomes. Although JHS has comprehensively assessed a wide variety of CVD risk factors, a notable gap has been the absences of objective assessment of sleep disordered breathing (SDB) and sleep patterns. The importance of rectifying this gap is underscored by recent research from predominantly EA samples that have demonstrated that SDB and insufficient sleep each are associated with increased incidence of coronary heart disease, diabetes, and stroke. Our preliminary data also indicate that SDB may be more prevalent in the entirely AA JHS cohort than in predominantly white cohorts. Our long-range goal is to ameliorate CVD disparities by identifying ethnicity-specific modifiable risk factors. The proposed study will examine relationships among SDB, insufficient sleep, obesity, psycho- socio-cultural variables, and CVD risk factors in 1,200 members of the JHS cohort. Sleep apnea and sleep patterns will be objectively assessed using low burden but reliable in-home sleep apnea monitoring and wrist actigraphy. To assess intermediate measurements of CVD, particularly related to stroke and diabetes, intimal media thickness (IMT), blood pressure, and biochemical indices of glucose control and inflammation will be obtained using rigorous protocols. These data will be used to achieve three specific aims: (1) Identify risk factors for SDB and insufficient sleep in AAs, including novel measurements of major and minor stress and negative emotions relevant to minority populations; (2) Elucidate relationships between SDB severity, insufficient sleep, and risk for uncontrolled hypertension, stroke and diabetes; and (3) Quantify the extent to which SDB may statistically mediate relationships between obesity and traditional CVD risk factors. Our study will identify the role of sleep disorders as novel modifiabe risk factors for CVD in AAs, provide a basis for promoting better screening for SDB, and enhance scientific understanding of how disparities in stroke and intermediate CVD outcomes such as diabetes, hypertension, and dyslipidemia are impacted by sleep disorders. Finally, the results of our study will serve as the foundation for prospective analyses linking SDB to incident CVD events, morbidity, and mortality in AAs. PUBLIC HEALTH RELEVANCE: The proposed study will help us better understand how sleep disorders and too little sleep contribute to the risk for stroke, diabetes, and cardiovascular disease in African Americans. The data gathered by this study will help researchers develop future targeted health interventions to reduce the public health burden of cardiovascular disease and racial disparities in diabetes, hypertension and stroke.

描述（由申请人提供）：尽管国家旨在解决健康差异的举措，但非洲裔美国人（AAS）的心血管疾病率（CVD）比欧洲人（EAS）高。杰克逊心脏研究（JHS）成立于2000年，目的是生成数据，以支持降低AAS中CVD差异的公共卫生建议。这项具有里程碑意义的研究报告说，与其他美国其他大多数EA同伴相比，这一完全AA队列的糖尿病患病率和不受控制的高血压较高。肥胖症或其他传统危险因素不能解释危险因素的增加，这表明其他无法衡量的因素在影响不良心脏代谢结果中的潜在作用。尽管JHS已全面评估了各种CVD危险因素，但显着的差距是缺乏对睡眠无序呼吸（SDB）和睡眠方式的客观评估。纠正这一差距的重要性强调了主要的EA样品的最​​新研究表明，SDB和睡眠不足都与冠心病，糖尿病和中风的发病率增加有关。我们的初步数据还表明，SDB在完全的AA JHS队列中可能比主要是白色同类群体更为普遍。我们的远程目标是通过确定特定于种族的可修改风险因素来改善CVD差异。拟议的研究将研究SDB，睡眠不足，肥胖，社会文化变量和CVD风险因素之间的关系，JHS队列的1200名成员。睡眠呼吸暂停和睡眠方式将通过低负担，但可靠的家庭睡眠呼吸暂停监测和腕部表演进行客观评估。为了评估CVD的中间测量，特别是与中风和糖尿病有关的CVD，内膜培养基厚度（IMT），血压和葡萄糖控制和炎症的生化指标将使用严格的方案获得。这些数据将用于实现三个具体目标：（1）确定AAS中SDB和睡眠不足的危险因素，包括针对少数群体相关的重大和轻微压力以及负面情绪的新测量； （2）阐明SDB严重程度，睡眠不足以及不受控制的高血压，中风和糖尿病之间的关系； （3）量化SDB可以在多大程度上介导肥胖与传统CVD风险因素之间的关系的程度。我们的研究将确定睡眠障碍的作用是CVD在AAS中的新型型风险因素，为促进SDB的更好筛查提供了基础，并增强了对中风和中级CVD结果的科学理解，例如糖尿病，高血压，高血压和血脂异常会影响睡眠疾病。最后，我们的研究结果将成为将SDB与AAS中事件的CVD事件，发病率和死亡率联系起来的前瞻性分析的基础。 公共卫生相关性：拟议的研究将帮助我们更好地了解非洲裔美国人的睡眠障碍和睡眠太少如何促进中风，糖尿病和心血管疾病的风险。这项研究收集的数据将帮助研究人员发展未来的目标健康干预措施，以减轻糖尿病，高血压和中风的心血管疾病和种族差异的公共卫生负担。