Abstract MP087: Sleep Quality is Associated with Subclinical Cardiovascular Disease in Mid-Life Mexican Women

Abstract

Introduction: Sleep quantity has been associated with higher risk of cardiovascular disease (CVD), however little is known about the impact of sleep quality on subclinical CVD. Hypothesis: Poor sleep quality is associated with subclinical CVD. Methods: We assessed the relationship between sleep quality and common carotid artery intima media thickness (IMT) through a cross-sectional analysis of a sub sample of 442 disease-free women from the Mexican Teacher’s Cohort. Sleep quality was evaluated through the Pittsburgh Sleep Quality Index (PSQI) in an online questionnaire applied to participants in 2014-2016. We defined poor sleep quality as a PSQI score above 5. Right and left carotid IMT was measured at clinical visits in 2012, 2013 and 2016 through carotid ultrasound performed by trained neurologists; results were log-transformed. Subclinical CVD was defined as the mean of right and left IMT ≥0.8mm or the presence of an atherosclerotic plaque. Multivariable linear and logistic regression models were used to evaluate the association of sleep quality with IMT or subclinical CVD, respectively. Results: In women of 49±5 years, the prevalence of poor sleep quality was 41% (185 of 442) and of subclinical CVD was 12.2% (54 of 442). The multivariable-adjusted percent difference of IMT was 2.4% (95% CI 0.03, 4.9), greater amongst those with poor sleep versus adequate sleep quality. The odds of developing subclinical CVD in women with poor sleep quality were 2.2 (95% CI 1.2, 4.1) times greater than those with adequate sleep quality (figure). Additionally, further adjustments for stress and depressive symptoms attenuated the results and were no longer statistically significant. Conclusion: Poor sleep quality is associated with IMT and subclinical CVD in a population of middle-aged women and this association is potentially mediated by stress and depression. Further analysis is needed regarding this association.