Abstract P102: Risk of Incident Hypertension and Diabetes Mellitus in Habitual Snorers and Sleep Apneic Individuals; The Multiethnic Study of Atherosclerosis

Abstract

Background: Data regarding temporal association of sleep apnea and snoring with incident hypertension (HTN) and diabetes mellitus(DM) are limited. Hypothesis: We hypothesized that sleep apnea and snoring are associated with incident HTN and DM. Methods: Participants of age 45 - 65 years from 4 ethnicities (Asian, Hispanic, African American and Caucasian) without known cardiovascular disease from Multi Ethnic Study of Atherosclerosis (MESA) were administered a sleep questionnaire. HTN was defined as being on antihypertensive medication or blood pressure ≥140/90 mmHg. DM was defined as fasting blood glucose ≥126 mg/dL or use of antidiabetic medications. Participants with baseline HTN and DM were excluded. Cox proportional hazard models were constructed to evaluate the association of habitual snoring (defined as snoring on ≥3 days of week) and sleep apnea (self-report of diagnosis by doctor) with hypertension or diabetes. The analysis was adjusted for age, gender, race, body mass index (BMI), exercise, education. Two separate analyses were performed after excluding hypertensives and diabetics at baseline. Results: Out of 6618 participants, 6206 responded to the sleep questionnaire. There were 213 (3.4%) participants with sleep apnea and 1481 (23.8%) were categorized as habitual snorers. 98% of participants reporting sleep apnea also reported snoring. There were 1364 (38.7%) cases of incident hypertension and 619 (11.3%) incident DM over a period of 10 years. Habitual snoring and sleep apnea both were not associated with incident HTN. Habitual snoring was also not associated with incident DM. Sleep apnea was independently associated with incident DM (see table). Conclusion: Despite potential misclassification of sleep apnea due to self -report, our study shows a strong association between sleep apnea and incident DM but not with incident hypertension. The findings support future research addressing role of sleep apnea in development of DM.