Sleep-disordered breathing and cardiovascular disease: epidemiologic evidence for a relationship.

摘要: Epidemiology studies of SDB and CVD to date do not provide a conclusive answer the question degree which impacts or mortality due CVD. However, most seem be consistent with positive, but perhaps small, association. All findings discussed referred in this review are likely biased some degree. Bias can both towards underestimation (e.g., from mismeasurment SDB, over-control for intermediate factors) overestimation inadequate control confounders improper comparison groups), net magnitude competing biases undoubtedly varies study study. Small associations were found prospective population-based studies, one exception. The obvious methodologic problem these would result associations. case-control contrast, showed large associations, serious probably cause overestimation. marginal statistical significance reported cross-sectional analyses; limited by sample size. Although each individual could (and has been ) "dismissed" weaknesses, collectively they evidence that we cannot dismiss hypothesis causes In many cases, weak explained problems underestimation. fact, finding any association limitations past is remarkable. Perhaps important, date, conjunction biologically plausible mechanisms have sparked interest needed initiate undertaking Sleep Heart Health Study (SHHS)15 multicenter specifically designed investigate role incident coronary heart disease, stroke, increased blood pressure, allcause-mortality. A key feature home polysomnography performed on 6600 men women, 40 years age older, drawn samples other longitudinal studies. new data collected SHHS then linked amount cardiovascular risk factors available "parent" baseline now completed. Cross-sectional analyses history being analyzed, collection outcome underway. Results near future should greatly increase our ability assess