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Nocturia, sleep-disordered breathing, and cardiovascular morbidity in a community-based cohort.
Monday,2013-01-14 17:04 America/Los_Angeles — poolea2
| Title | Nocturia, sleep-disordered breathing, and cardiovascular morbidity in a community-based cohort. |
| Publication Type | Journal Article |
| Year of Publication | 2012 |
| Authors | Parthasarathy, S, Fitzgerald, MP, Goodwin, JL, Unruh, M, Guerra, S, Quan, SF |
| Journal | PLoS One |
| Volume | 7 |
| Issue | 2 |
| Pagination | e30969 |
| Date Published | 2012 |
| ISSN | 1932-6203 |
| Keywords | Aged, Cardiovascular Diseases, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Nocturia, Polysomnography, Sleep Apnea Syndromes |
| Abstract | <p><b>BACKGROUND: </b>Nocturia has been independently associated with cardiovascular morbidity and all-cause mortality, but such studies did not adjust for sleep-disordered breathing (SDB), which may have mediated such a relationship. Our aims were to determine whether an association between nocturia and cardiovascular morbidity exists that is independent of SDB. We also determined whether nocturia is independently associated with SDB.</p><p><b>METHODOLOGY/PRINCIPAL FINDINGS: </b>In order to accomplish these aims we performed a cross-sectional analysis of the Sleep Heart Health Study that contained information regarding SDB, nocturia, and cardiovascular morbidity in a middle-age to elderly community-based population. In 6342 participants (age 63±11 [SD] years, 53% women), after adjusting for known confounders such as age, body mass index, diuretic use, diabetes mellitus, alpha-blocker use, nocturia was independently associated with SDB (measured as Apnea Hypopnea index >15 per hour; OR 1.3; 95%CI, 1.2-1.5). After adjusting for SDB and other known confounders, nocturia was independently associated with prevalent hypertension (OR 1.23; 95%CI 1.08-1.40; P = 0.002), cardiovascular disease (OR 1.26; 95%CI 1.05-1.52; P = 0.02) and stroke (OR 1.62; 95%CI 1.14-2.30; P = 0.007). Moreover, nocturia was also associated with adverse objective alterations of sleep as measured by polysomnography and self-reported excessive daytime sleepiness (P<0.05).</p><p><b>CONCLUSIONS/SIGNIFICANCE: </b>Nocturia is independently associated with sleep-disordered breathing. After adjusting for SDB, there remained an association between nocturia and cardiovascular morbidity. Such results support screening for SDB in patients with nocturia, but the mechanisms underlying the relationship between nocturia and cardiovascular morbidity requires further study. MeSH terms: Nocturia, sleep-disordered breathing, obstructive sleep apnea, sleep apnea, polysomnography, hypertension.</p> |
| DOI | 10.1371/journal.pone.0030969 |
| Alternate Journal | PLoS ONE |
| PubMed ID | 22328924 |
| PubMed Central ID | PMC3273490 |
| Grant List | 5R01DK077785 / DK / NIDDK NIH HHS / United States U01HL53937 / HL / NHLBI NIH HHS / United States U01 HL053916 / HL / NHLBI NIH HHS / United States R01 DK077785 / DK / NIDDK NIH HHS / United States U01HL64360 / HL / NHLBI NIH HHS / United States 1R01HL095748 / HL / NHLBI NIH HHS / United States U01 HL063463 / HL / NHLBI NIH HHS / United States U01HL53938 / HL / NHLBI NIH HHS / United States U01 HL053938 / HL / NHLBI NIH HHS / United States U01HL53934 / HL / NHLBI NIH HHS / United States U01 HL064360 / HL / NHLBI NIH HHS / United States R01 HL095748 / HL / NHLBI NIH HHS / United States U01 HL053941 / HL / NHLBI NIH HHS / United States K24 DK075967 / DK / NIDDK NIH HHS / United States U01HL63429 / HL / NHLBI NIH HHS / United States U01HL53931 / HL / NHLBI NIH HHS / United States U01HL53941 / HL / NHLBI NIH HHS / United States U01 HL053934 / HL / NHLBI NIH HHS / United States U01HL53916 / HL / NHLBI NIH HHS / United States U01 HL063429 / HL / NHLBI NIH HHS / United States DK075967-03 / DK / NIDDK NIH HHS / United States U01 HL053937 / HL / NHLBI NIH HHS / United States U01HL53940 / HL / NHLBI NIH HHS / United States U01HL63463 / HL / NHLBI NIH HHS / United States U01 HL053931 / HL / NHLBI NIH HHS / United States |