Association between Snoring and Risk Factors of Cardiovascular Disease in Urban Middle-aged and Elderly People in Chengdu_West China Medical Journal

Authors：

LUuml , Zhengbing ,  HE Sen

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

HE Sen, Email: chenxp2@yahoo.cn

Keywords：

打鼾; 高血压; 心血管疾病

DOI：

10.7507/1002-0179.20130156

Video：

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目的　阻塞性睡眠呼吸暂停低通气综合征（OSAHS）可引起心血管疾病发生增高，是高血压病及冠心病等的独立危险因素。打鼾是OSAHs的主要临床症状。本研究的主要目的是了解成都地区自然人群打鼾发生情况及其与心血管疾病危险因素的关系。方法　2007年在成都市成华区采用随机抽样方法对男、女性共711人进行了心血管疾病危险因素调查[年龄45～80岁，平均（3.28 ± 6.25）岁，男性患者占所有患者的57.8%]，主要包括问卷调查、体格检查及血液学检查等，其中打鼾调查主要包括打鼾时间、次数及憋醒情况。将与打鼾相关的3个指标综合考虑后，计算出打鼾的严重程度，并分析了其与心血管疾病危险因素的关系。结果　男性人群中打鼾率较女性高（62.0%、51.0%，P=0.003），且重度及极重度打鼾率也较女性高。随着打鼾的严重程度增加，体质量指数、血肌酐及尿酸等心血管疾病危险因素逐渐升高（趋势P均＜0.05），而高密度脂蛋白胆固醇逐渐降低（P=0.001）。另外，随着打鼾的严重程度增加，高血压患病率及收缩压也逐渐升高，但无统计学意义（趋势P=0.063，0.08）。结论　成都地区中老年城镇人群的打鼾率较高，且男性高于女性。另外，随着打鼾的严重程度增加，心血管疾病危险因素也逐渐升高。这提示我们在临床工作中，对于打鼾的患者需要加强心血管疾病危险因素的筛查及干预，以期减少它的发生发展。

Citation： LUuml,Zhengbing,HE Sen,CHEN Xiaoping.. Association between Snoring and Risk Factors of Cardiovascular Disease in Urban Middle-aged and Elderly People in Chengdu. West China Medical Journal, 2013, 28(4): 485-488. doi: 10.7507/1002-0179.20130156 Copy

1.	Seckin OU. Snoring and obstructive sleep apnea[J]. Med Clin N Am, 2010, 94(5): 1047-1055.
2.	Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea[J]. Am J Resp Crit Care, 2002, 166(2): 159-165.
3.	Leineweber C, Kecklund G, Janszky I, et al. Snoring and progression of coronary artery disease: the stockholm female coronary angiography study[J]. Sleep, 2004, 27(7): 1344-1349.
4.	Kim J, Yi H, Shin KR, et al. Snoring as an independent risk factor for hypertension in the nonobese population: the korean health and genome study[J]. Am J Hypertens, 2007, 20(8): 819-824.
5.	Thomas GN, Jiang C, Lao X, et al. Snoring and vascular risk factors and disease in a low-risk Chinese population: the guangzhou biobank cohort study[J]. Sleep , 2006, 29(7): 896-900.
6.	Hoffstein V. Snoring[J]. Chest, 1996, 109(1): 201-222.
7.	刘建红, 梁大华, 韦彩周, 等. 广西地区打鼾人群血压状况分析 [J]. 中华结核和呼吸杂志, 2007, 30(5): 347-351.
8.	Lindberg E, Berne C, Franklin KA, et al. Snoring and daytime sleepiness as risk factors for hypertension and diabetes in women-a population-based study[J]. Resp Med, 2007, 101(6): 1283-1290.
9.	Zamarrón C, Gude F, Otero YO, et al. Snoring and myocardial infarction: a 4-year follow-up study[J]. Resp Med, 1999, 93(2): 108-112.
10.	Lindberg E, Janson C, Gislason T, et al. Snoring and hypertension: a 10 year follow-up[J]. Eur Respir J, 1998, 11(4): 884-889.
11.	Koskenvuo M, Kaprio J, Telakivi T, et al. Snoring as a risk factor for ischaemic heart disease and stroke in men[J]. BMJ, 1987, 294(6563): 16-19.
12.	World Health Organization. Multinational monitoring of trends and determinants in cardiovascular diseases (MONICA Project) and manual of operation[R]. Geneva, Switzerland: World Health Organization, Cardiovascular Disease Unit, 1983.
13.	Kim J, Yi H, Shin KR, et al. Snoring as an independent risk factor for hypertension in the nonobese population: the korean health and genome Study[J]. Am J Hypertens, 2007, 20(8): 819-824.
14.	Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up[J]. Am J Respir Crit Care Med, 2002, 166(2): 159-165.
15.	Cho N, Joo S, Kim J, et al. Relation of habitual snoring with components of metabolic syndrome in Korean adults[J]. Diabetes Res and Clin Pr, 2006, 71(3): 256-263.
16.	Dart RA, Gregoire JR, Gutterman DD, et al. The association of hypertension and secondary cardiovascular disease with sleep-disordered breathing[J]. Chest, 2003, 123(1): 244-260.
17.	Hu FB, Willett WC, Manson JE, et al. Snoring and risk of cardiovascular disease in women[J]. J Am Coll Cardiol, 2000, 35(2): 308-313.
18.	YOUNG, L Finn, KM Hla, et al. Snoring as part of a dose-response relationship between sleep-disordered breathing and blood pressure[J]. Sleep, 1996, 19(Suppl 10): 202-205.
19.	Gozal D, Kheirandish L. Oxidant stress and inflammation in the snoring child: confluent pathways to upper airway pathogenesis and end-organ morbidity[J]. Sleep Med Rev, 2006, 10(2): 83-96.
20.	Yeboah J, Redline S, Johnson C, et al. Association between sleep apnea, snoring, incident cardiovascular events and all-cause mortality in an adult population: MESA[J]. Atherosclerosis, 2011, 219(2): 963-968.
21.	Lao XQ, Neil Thomas G, Jiang CQ, et al. Obesity, high-sensitive C-reactive protein and snoring in older Chinese: The guangzhou biobank cohort study[J]. Resp Med, 2010, 104(11): 1750-1756.
22.	Shin C, Kim J, Kim J, et al. Association of habitual snoring with glucose and insulin metabolism in nonobese korean adult men[J]. Am J Resp Crit Care, 2005, 171(3): 287-291.
23.	Al-Delaimy WK, Manson JE, Willett WC, et al. Snoring as a risk factor for typeⅡ diabetes mellitus: a prospective study[J]. Am J Epidemiol, 2002, 155(5): 387-393.

1. 　Seckin OU. Snoring and obstructive sleep apnea[J]. Med Clin N Am, 2010, 94(5): 1047-1055.
2. 　Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea[J]. Am J Resp Crit Care, 2002, 166(2): 159-165.
3. 　Leineweber C, Kecklund G, Janszky I, et al. Snoring and progression of coronary artery disease: the stockholm female coronary angiography study[J]. Sleep, 2004, 27(7): 1344-1349.
4. 　Kim J, Yi H, Shin KR, et al. Snoring as an independent risk factor for hypertension in the nonobese population: the korean health and genome study[J]. Am J Hypertens, 2007, 20(8): 819-824.
5. 　Thomas GN, Jiang C, Lao X, et al. Snoring and vascular risk factors and disease in a low-risk Chinese population: the guangzhou biobank cohort study[J]. Sleep , 2006, 29(7): 896-900.
6. 　Hoffstein V. Snoring[J]. Chest, 1996, 109(1): 201-222.
7. 　刘建红, 梁大华, 韦彩周, 等. 广西地区打鼾人群血压状况分析 [J]. 中华结核和呼吸杂志, 2007, 30(5): 347-351.
8. 　Lindberg E, Berne C, Franklin KA, et al. Snoring and daytime sleepiness as risk factors for hypertension and diabetes in women-a population-based study[J]. Resp Med, 2007, 101(6): 1283-1290.
9. 　Zamarrón C, Gude F, Otero YO, et al. Snoring and myocardial infarction: a 4-year follow-up study[J]. Resp Med, 1999, 93(2): 108-112.
10. 　Lindberg E, Janson C, Gislason T, et al. Snoring and hypertension: a 10 year follow-up[J]. Eur Respir J, 1998, 11(4): 884-889.
11. 　Koskenvuo M, Kaprio J, Telakivi T, et al. Snoring as a risk factor for ischaemic heart disease and stroke in men[J]. BMJ, 1987, 294(6563): 16-19.
12. 　World Health Organization. Multinational monitoring of trends and determinants in cardiovascular diseases (MONICA Project) and manual of operation[R]. Geneva, Switzerland: World Health Organization, Cardiovascular Disease Unit, 1983.
13. 　Kim J, Yi H, Shin KR, et al. Snoring as an independent risk factor for hypertension in the nonobese population: the korean health and genome Study[J]. Am J Hypertens, 2007, 20(8): 819-824.
14. 　Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up[J]. Am J Respir Crit Care Med, 2002, 166(2): 159-165.
15. 　Cho N, Joo S, Kim J, et al. Relation of habitual snoring with components of metabolic syndrome in Korean adults[J]. Diabetes Res and Clin Pr, 2006, 71(3): 256-263.
16. 　Dart RA, Gregoire JR, Gutterman DD, et al. The association of hypertension and secondary cardiovascular disease with sleep-disordered breathing[J]. Chest, 2003, 123(1): 244-260.
17. 　Hu FB, Willett WC, Manson JE, et al. Snoring and risk of cardiovascular disease in women[J]. J Am Coll Cardiol, 2000, 35(2): 308-313.
18. 　YOUNG, L Finn, KM Hla, et al. Snoring as part of a dose-response relationship between sleep-disordered breathing and blood pressure[J]. Sleep, 1996, 19(Suppl 10): 202-205.
19. 　Gozal D, Kheirandish L. Oxidant stress and inflammation in the snoring child: confluent pathways to upper airway pathogenesis and end-organ morbidity[J]. Sleep Med Rev, 2006, 10(2): 83-96.
20. 　Yeboah J, Redline S, Johnson C, et al. Association between sleep apnea, snoring, incident cardiovascular events and all-cause mortality in an adult population: MESA[J]. Atherosclerosis, 2011, 219(2): 963-968.
21. 　Lao XQ, Neil Thomas G, Jiang CQ, et al. Obesity, high-sensitive C-reactive protein and snoring in older Chinese: The guangzhou biobank cohort study[J]. Resp Med, 2010, 104(11): 1750-1756.
22. 　Shin C, Kim J, Kim J, et al. Association of habitual snoring with glucose and insulin metabolism in nonobese korean adult men[J]. Am J Resp Crit Care, 2005, 171(3): 287-291.
23. 　Al-Delaimy WK, Manson JE, Willett WC, et al. Snoring as a risk factor for typeⅡ diabetes mellitus: a prospective study[J]. Am J Epidemiol, 2002, 155(5): 387-393.

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