Self-reported snoring and incident cardiovascular disease events: results from the Jackson Heart Study
Evidence suggests that snoring is associated with increased risk for cardiovascular disease (CVD) events such as myocardial infarction and stroke. Limited data exists pertaining to this association among African Americans. We therefore examined the association between self-reported habitual snoring and incident CVD in the Jackson Heart Study (JHS), a population-based cohort study of African Americans.
Self-reported data on snoring and risk factors for CVD were collected at baseline (2000–2004). Participants were followed prospectively for the development of incident CVD. Habitual snoring was defined as present if the participants reported it as “often” or “almost always” or absent if reported as “sometimes,” “never,” or “seldom.” A CVD event included stroke, myocardial infarction, coronary revascularization procedure, or fatal CHD event. Cox proportional hazards models assessed the independent association between self-reported habitual snoring and incident CVD event adjusting for multiple covariates, including age, sex, hypertension, body mass index, diabetes, hypercholesterolemia, and smoking status.
The snorer group consisted of 787 participants (mean age 52.1 years) and the nonsnorer group consisted of 3708 participants (mean age 54.9 years). Frequency of incident CVD events in the snorer group was not significantly different from the nonsnorer group. The fully adjusted hazard ratio for a CVD event in the snorer group was 1.01 (95% confidence interval [0.69, 1.47], p value of 0.96).
In conclusion, self-reported habitual snoring was not associated with incident CVD among this large African American cohort. Future studies providing objective data on snoring and sleep apnea may provide more information on the snoring-CVD association among African Americans.
Identification Number: NCT00005485
KeywordsSnoring Cardiovascular disease Stroke Coronary artery disease Sleep apnea
Drs. Rosen, Shah, and Kaplan contributed to the study design. Na Guo and Michael Rueschman did the statistical analysis. Drs. Rosen, Shah, Redline, Min, and Michael Rueschman interpreted the data. Drs. Redline, Shah, Kundel, Min, and Rosen contributed to the review of the data analysis. Dr. Rosen was the primary author who was responsible for the writing of this manuscript. Many sections of the manuscript were further edited by Dr. Shah and Dr. Kundel after Dr. Rosen was unable to work on revisions of this manuscript due to graduation from fellowship. The authors thank the participants and data collection staff of the Jackson Heart Study.
The Jackson Heart Study (JHS) is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I/HHSN26800001), and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I and HHSN268201800012I) contracts from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute for Minority Health and Health Disparities (NIMHD). The study analysis was also supported by funding from Dr. Shah’s National Institute of Health/National Heart, Lung, and Blood Institute Research Career Development Award (5K23HL125923-03).
Compliance with ethical standards
Declaration of interests
The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services.
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent was obtained from all individual participants included in the study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 12.Yeboah J, Redline S, Johnson C et al (2011) Association between sleep apnea, snoring, incident cardiovascular events and all-cause mortality in an adult population: MESA. Atherosclerosis 219:963–968. https://doi.org/10.1016/j.atherosclerosis.2011.08.021 CrossRefGoogle Scholar
- 14.Drager LF, Lorenzi-Filho G (2008) Heavy snoring and carotid atherosclerosis: is there more than an association? Sleep 31:1335 discussion 1337Google Scholar
- 15.Lee SA, Amis TC, Byth K et al (2008) Heavy snoring as a cause of carotid artery atherosclerosis. Sleep 31:1207–1213Google Scholar
- 16.Sands M, Loucks EB, Lu B et al (2012) Self-reported snoring and risk of cardiovascular disease among postmenopausal women (from the Women’s Health Initiative). Am J Cardiol. https://doi.org/10.1016/j.amjcard.2012.10.039
- 19.Taylor HA Jr (2005) Ethn Dis 15:S6-1–S6-3Google Scholar
- 20.Fuqua SR, Wyatt SB, Andrew ME et al (2005) Recruiting African-American research participation in the Jackson Heart Study: methods, response rates, and sample description. Ethn Dis 15:S6-18–S6-29Google Scholar
- 21.Payne TJ, Wyatt SB, Mosley TH et al (2005) Sociocultural methods in the Jackson Heart Study: conceptual and descriptive overview. Ethn Dis 15:S6-38–S6-48Google Scholar
- 23.Keku E, Rosamond W, Taylor HA Jr et al (2005) Cardiovascular disease event classification in the Jackson Heart Study: methods and procedures. Ethn Dis 15:S6-62–S6-70Google Scholar