Abstract 9699: Short Sleep Duration and Glycemic Control Have Synergic Effect on Cardiovascular Events in Hypertensive Patients
Backgrounds: Short duration of sleep is associated with increased prevalence of diabetes. We tested the hypothesis that short sleep duration is not only a risk of diabetes, but the combination of these is associated with increased risk of incident cardiovascular disease (CVD).
Methods: We analyzed 1255 hypertensives who performed ambulatory BP monitoring (ABPM). The mean age was 70.4 ± 9.9 years, and they were followed for 50 ± 23 months. Sleep duration was evaluated by self-report. Diabetes was defined by a history or taking diabetic medications. Short sleep duration was defined as the 20th percentile of the whole population (<7.5hrs). Hard CVD event was defined as either myocardial infarction, stroke, or sudden cardiac death; and All CVD event was defined as Hard CVD events plus angina, heart failure and end stage renal disease. Cox proportional hazard models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) controlling for significant covariates.
Results: There were 299 diabetic and 956 non-diabetic subjects. The sleep duration was significantly shorter in diabetics than in non-diabetics (8.3±1.4 vs. 8.5±1.4, P=0.005). There were a total of 99 Hard CVD events and 123 All CVD events. When the subjects were divided by 4 categories: Diabetes+Short sleep (n=94); Diabetes+ Long sleep (n=205); Non-diabetes+Short sleep (n=257); Non-diabetes+Long sleep (n=699), the group with Diabetes+Short sleep had significantly higher incidence of Hard CVD events (HR=2.27, 95%CI=1.17-4.42, P=0.015) and All CVD events (HR=2.47, 1.37-4.43, P=0.003) compared with the group with Non-diabetes+Long sleep independent of age, sex, BMI, creatinine, and 24-h SBP. Although there was no interactions between diabetes and short duration of sleep on the impact of CVD events, a subanalysis of diabetic subjects (N=203) have shown that there were significant interactions between the sleep duration and average hemoglobin A1c levels on the impact of Hard and All CVD events.
Conclusion: The combination of diabetes and short duration of sleep was associated with higher risk of incident cardiovascular disease (CVD) than those without. Worse glycemic control along with short sleep duration had a tendency to act synergistically as risks of future cardiovascular events.
- © 2011 by American Heart Association, Inc.