Age-specific associations between habitual snoring and cardiovascular diseases in China: a 10-year cohort study.

Abstract

BACKGROUND\nThere is limited convincing evidence of the relationship between habitual snoring and cardiovascular diseases (CVDs).\n\n\nRESEARCH QUESTION\nIs habitual snoring associated with total CVD and CVD subtypes in different age groups of Chinese adults?\n\n\nSTUDY DESIGN AND METHODS\nThe China Kadoorie Biobank study enrolled over 0.5 million adults aged 30 to 79 years from 10 regions in China. Snoring status and other baseline characteristics were collected from 2004 to 2008 using an interviewer-administered laptop-based questionnaire. The present analysis included 489,583 participants without stroke or coronary heart disease at baseline. Cox proportional hazards models were used to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of CVDs for habitual snoring versus nonhabitual snoring.\n\n\nRESULTS\nDuring a median follow-up of 9.6 years, 130,935 participants developed CVDs. Associations between habitual snoring and CVDs varied with age. Among participants aged <50 years at baseline, habitual snoring was associated with an increased risk of total CVD (HR: 1.11, 95% CI: 1.07-1.14) after adjustment for known CVD risk factors including systolic blood pressure. The corresponding HRs (95% CIs) for ischemic heart disease, ischemic stroke, and hemorrhagic stroke were 1.18 (1.12-1.24), 1.12 (1.05-1.19), and 1.05 (0.92-1.19), respectively. However, such associations in adults aged 50∼64 years were much weaker, and no statistically significant association was observed among individuals aged ≥65 years. Age-specific risk estimates were generally similar across sex and obesity subgroups.\n\n\nINTERPRETATION\nHabitual snoring was associated with increased risks of total CVD, ischemic heart disease, ischemic stroke, but not hemorrhagic stroke in Chinese and these associations were mainly limited to those aged<50 years. Clinicians in China are suggested to identify snoring, particularly in younger adults.