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The Lifestyle-Related Cardiovascular Risk Is Modified by Sleep Patterns

  • Qiying Song
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA

    Maternal-Fetal Medicine Institute, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen

    Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
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  • Mengying Wang
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA

    Department of Epidemiology and Biostatistic, School of Public Health, Peking University, Beijing, China
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  • Tao Zhou
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
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  • Dianjianyi Sun
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA

    Department of Epidemiology and Biostatistic, School of Public Health, Peking University, Beijing, China
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  • Hao Ma
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
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  • Xiang Li
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
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  • Yoriko Heianza
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
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  • Lu Qi
    Correspondence
    Correspondence: Address to Lu Qi, MD, PhD, Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, Ste 1724, New Orleans, LA 70112
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA

    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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Published:February 09, 2022DOI:https://doi.org/10.1016/j.mayocp.2021.08.031

      Abstract

      Objective

      To prospectively assess whether sleep patterns modified lifestyle-associated cardiovascular disease (CVD) risk.

      Patients and Methods

      This study included 393,690 participants without CVD at baseline measurements between March 13, 2006, and October 1, 2010, from UK Biobank. A lifestyle score was calculated on the basis of the 4 lifestyle factors (smoking, alcohol consumption, physical activity, and diet), and sleep patterns were constructed based on sleep duration, chronotype, insomnia, snoring, and daytime dozing.

      Results

      During a median follow-up of 8.93 years, we observed 10,218 incident CVD events, including 6595 myocardial infarctions (MIs) and 3906 strokes. We found that sleep patterns significantly modified the relations of the lifestyle score with incident CVD (P for interaction =.007) and MI (P for interaction =.004). Among participants with a poor sleep pattern, unfavorable lifestyle (per score increase) was associated with 25% (95% CI, 13% to 39%) and 29% (95% CI, 13% to 47%) increased risks for CVD and MI, while among participants with a healthy sleep pattern, unfavorable lifestyle was associated with 18% (95% CI, 15% to 21%) and 17% (95% CI, 13% to 21%) increased risks for CVD and MI.

      Conclusion

      Our results indicate that adherence to a healthy sleep pattern may attenuate the CVD risk associated with an unfavorable lifestyle.

      Abbreviations and Acronyms:

      BMI (body mass index), CVD (cardiovascular disease), HR (hazard ratio), ICD-10(9) (International Classification of Diseases, Tenth (Ninth) Revision), MI (myocardial infarction), PRS (polygenic risk score), PRS-DUR (polygenic risk score of sleep duration), SNP (single-nucleotide polymorphism)
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