Abstract 17874: The Association of Sleep Disturbance and Depression with Prodromal Symptoms of Coronary Heart Disease in Women: Secondary Data Analysis from a Multi-Site, Longitudinal Study
Purpose: Estimate the association between sleep disturbance and depression with prodromal symptoms of coronary heart disease (CHD) in women.
Background: Over 240,000 women die from CHD yearly. CHD kills more women than all other causes of death combined. Sleep disturbance and depression have been implicated in the development of CHD in women. The Nurses study, (n = 71,617) found an age-adjusted relative risk of 1.82 (95% CI: 1.34-2.41) for women sleeping <5 hours per night. Depression is also associated with an increased risk of CHD and is commonly comorbid with it. Few studies have collected longitudinal data to examine the correlation of sleep disturbance and depression with prodromal symptoms of CHD in women. This is important because the identification of risk factors and prodromal symptoms may assist clinicians in diagnosing CHD earlier in women.
Methods: Data for this multi-site, longitudinal study were collected from women without CHD from cardiology practices in two southern states. They were queried every three months for two years regarding sleep disturbance, depression, and prodromal symptoms of CHD, measured as a positive report of sleep disturbance, score of 16 or greater on the Center for Epidemiologic Studies Depression Scale, and the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS) prodromal score. Generalized estimating equations were used adjusting for repeated surveys.
Results: 1074 subjects (mean age at baseline 53.8 + 13.9 years; 141 (13%) black) with 8593 surveys were analyzed. Depression, Sleep Disturbance and their interaction were significantly associated with increased MAPMISS prodromal score adjusting for age and race. Subjects with Sleep Disturbance without Depression had an increase of 21.5 points in MAPMISS (P < 0.001), while those with Depression and no Sleep Disturbance had an increase of 19.3 points (P < 0.001). In the presence of both Depression and Sleep Disturbance, MAPMISS increased 53.2 points (P<0.001).
Conclusions: Sleep Disturbance and Depression were strongly associated with CHD prodromal symptoms in this sample. The assessment of sleep disturbance, depression, and prodromal symptoms may help clinicians diagnose CHD earlier, thus reducing the number one killer of women.
Author Disclosures: C. Pettey: None. C.J. Swearingen: None. J.C. McSweeney: Research Grant; Significant; NIH/NINR.
- © 2014 by American Heart Association, Inc.