Article Text
Abstract
Background Sleep-disordered breathing (SDB) is associated with the increased cardiovascular (CV) morbidity, however, it is not considered in the standard risk stratification scales.
Purpose We evaluated the association between self-reported SDB (population-based sample) and two common risk stratification scales: SCORE and ASCVD.
Methods We selected 526 adults without known CV-disease (156 males, 30%; mean age 54±6.8years) from the population-based sample (the epidemiological study ESSE-RF). All subjects were interviewed (lifestyle, medical history, complaints) using standard questionnaire. We assessed self-reported snore (‘Do you snore?’) and sleep apnea (‘Do you have sleep apneas?’). Affirmative response was considered diagnostic. The 10-year risk of fatal CV-events was assessed by the SCORE high-risk charts calculator and ASCVD risk estimator.
Results Overall, 288 (55%) subjects had snoring, while 27 (5%) reported sleep apneas. Based on the SCORE the participants were divided as following: low risk (<1%) was the most predominant category (35%); moderate risk (≥1% and <5%)-44%, high risk (5–10%)-16%, and very high risk-5%. Based on the ASCVD scale the subjects were divided as following: low risk (<5%) consisted 55,4%; borderline (6–7,4%)-16,3%, intermediate (7,5–19,9%)-23%, and high-5,3%. High-to-very-high SCORE-risk was more frequent in subjects with self-reported snoring compared to non-snorers: 27.1% vs. 7.5%, respectively (Chi-square=44.5,p<0.001). No association was found between self-reported sleep apneas and CV-risk (p>0.05). Similarly, intermediate-high ASCVD-risk is found more often in snorers vs. non-snorers (34.7% vs. 16.4%, respectively,Chi-square=22.5,p<0.001), with no association between self-reported sleep apneas and ASCVD-risk (p>0.05). Logistic multiple regression demonstrated an association between SCORE-risk and self-reported snoring (OR=3.21 95%CI 1.82–5.67,p<0.001); between self-reported snoring and ASCVD-risk (OR=2.24 95%CI 1.35–3.71,p=0.002).
Conclusions In Russian population-based sample self-reported snoring (unlike self-reported sleep apnea) is associated with the increased 10-year risk of CV-events independently of the risk stratification scale. The lack of association between CV-risk and sleep apnea might be related to the subjective assessment.
(grant#НШ-5508.2018.7)