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Sleep apnea and retinal signs in cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis.

Publication ,  Journal Article
Chew, M; Xie, J; Klein, R; Klein, B; Cotch, MF; Redline, S; Wong, TY; Cheung, N
Published in: Sleep Breath
March 2016

PURPOSE: The aim of the study was to examine the relationship between sleep apnea, retinal vascular caliber and retinopathy, and their impact on cardiovascular disease (CVD) risk. METHODS: A multi-ethnic cohort of 5,803 participants was examined based on standardized grading of retinal vascular caliber and retinopathy from digital fundus photographs, self-reported physician-diagnosed sleep apnea (PDSA), and incident cardiovascular events. RESULTS: In women, PDSA was associated with narrower arterioles (regression coefficient [β] -5.76; 95 % confidence Interval [CI] -8.51, -3.02) after adjusting for cardio-metabolic risk factors. The incident rate ratio (IRR) of CVD was also associated with narrower arterioles (IRR for highest versus lowest tertile 1.91; 95 % CI 1.08, 3.38). In men, PDSA was not associated with arteriolar caliber. However, incident CVD was associated with narrower arterioles (IRR 1.67; 95 % CI 1.10, 2.52), wider venules (IRR 1.71; 95 % CI 1.13, 2.59) and PDSA (IRR 2.03, 95 % CI 1.17, 3.51). The IRR of CVD in men with PDSA increased minimally to 2.06 (95 % CI 1.18, 3.56) after adjustment for retinal arteriolar and venular caliber. Combining women and men, the IRR of CVD was 3.41 (95 % CI 1.79, 6.50) in those with both PDSA and narrower retinal arterioles. CONCLUSIONS: Sleep apnea was associated with narrower retinal arterioles in women but not in men. However, sleep apnea was also associated with incident CVD in men. These suggest potential gender differences in susceptibility to microvascular disease in association with sleep apnea.

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Published In

Sleep Breath

DOI

EISSN

1522-1709

Publication Date

March 2016

Volume

20

Issue

1

Start / End Page

15 / 23

Location

Germany

Related Subject Headings

  • White People
  • Vasoconstriction
  • Statistics as Topic
  • Sleep Apnea, Obstructive
  • Sex Factors
  • Risk Factors
  • Retinal Vessels
  • Respiratory System
  • Prospective Studies
  • Middle Aged
 

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Chew, M., Xie, J., Klein, R., Klein, B., Cotch, M. F., Redline, S., … Cheung, N. (2016). Sleep apnea and retinal signs in cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis. Sleep Breath, 20(1), 15–23. https://doi.org/10.1007/s11325-015-1177-z
Chew, Merwyn, Jing Xie, Ronald Klein, Barbara Klein, Mary Frances Cotch, Susan Redline, Tien Yin Wong, and Ning Cheung. “Sleep apnea and retinal signs in cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis.Sleep Breath 20, no. 1 (March 2016): 15–23. https://doi.org/10.1007/s11325-015-1177-z.
Chew M, Xie J, Klein R, Klein B, Cotch MF, Redline S, et al. Sleep apnea and retinal signs in cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis. Sleep Breath. 2016 Mar;20(1):15–23.
Chew, Merwyn, et al. “Sleep apnea and retinal signs in cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis.Sleep Breath, vol. 20, no. 1, Mar. 2016, pp. 15–23. Pubmed, doi:10.1007/s11325-015-1177-z.
Chew M, Xie J, Klein R, Klein B, Cotch MF, Redline S, Wong TY, Cheung N. Sleep apnea and retinal signs in cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis. Sleep Breath. 2016 Mar;20(1):15–23.
Journal cover image

Published In

Sleep Breath

DOI

EISSN

1522-1709

Publication Date

March 2016

Volume

20

Issue

1

Start / End Page

15 / 23

Location

Germany

Related Subject Headings

  • White People
  • Vasoconstriction
  • Statistics as Topic
  • Sleep Apnea, Obstructive
  • Sex Factors
  • Risk Factors
  • Retinal Vessels
  • Respiratory System
  • Prospective Studies
  • Middle Aged