Framingham 10-year Cardiovascular Disease Research Articles

The effectiveness of sleep breathing impairment index in assessing obstructive sleep apnea severity.

Using the apnea-hypopnea index (AHI) and the sleep breathing impairment index (SBII) to assess the severity of obstructive sleep apnea (OSA) to study how effective SBII is in assessing the severity and cardiovascular disease (CVD) prognosis. This study comprised a total of 147 patients with diagnosed OSA. The AHI and SBII were calculated from the polysomnography. Patients were enrolled in the cluster analysis using 20 symptoms and the SBII. The prognostic indicator was determined as the moderate-to-high Framingham 10-year CVD risk. Cluster analysis revealed 3 separate groups: cluster 1 (n = 45, 30.61%) had the lowest symptoms complaints yet the highest PSQI score; cluster 2 (n = 70, 47.62%) had considerably increased symptom complaints but the lowest Epworth Sleepiness Scale score, intermediate PSG indices, a higher low arousal threshold possibility, and a lower SBII quantile; cluster 3 (n = 32, 21.77%) had the largest percentage of smokers, a predominant symptom of restless sleep, severe PSG characteristics, a lower low arousal threshold likelihood, a greater SBII quantile and a higher Framingham CVD risk. There were no differences in severity indicated by AHI between groups. Higher SBII rather than AHI is associated with an increased 10-year CVD risk. SBII provides higher sensitivity when evaluating OSA severity and better predictive capabilities for CVD outcomes. SBII may be a more effective substitute for AHI in the future. Dai L, Cao W, Luo J, Huang R, Xiao Y. The effectiveness of sleep breathing impairment index in assessing obstructive sleep apnea severity. J Clin Sleep Med. 2023;19(2):267-274.

The Association Between Sleep Breathing Impairment Index and Cardiovascular Risk in Male Patients with Obstructive Sleep Apnea.

BackgroundObstructive sleep apnea (OSA) is related to multiple complications including insulin resistance (IR), endothelial dysfunction, and increased risk of cardiovascular disease (CVD). The apnea–hypopnea index (AHI) was widely used to measure OSA severity but poorly correlated with complications above. This study aimed to evaluate whether a new metric, the sleep breathing impairment index (SBII), was associated with cardiovascular risk in patients with OSA.MethodsThis study enrolled 140 consecutive male OSA patients without overt atherosclerotic CVD events, including coronary heart disease, stroke, peripheral vascular disease, or heart failure. Data on baseline medical history, anthropometric and polysomnographic parameters, fasting biochemical measurements and endothelial function tests, and common questionnaires were collected. The SBII was calculated by the product of the duration of each obstructive event and the associated desaturation area. The primary outcome was the moderate-to-high Framingham 10-year CVD risk.ResultsThe median age of enrolled patients was 40 (35–48) years. Eighty subjects had a moderate-to-high Framingham CVD risk. Patients with SBII in the third and fourth quartile had an increased proportion of moderate-to-high Framingham CVD risk with an adjusted OR 6.28 (95% CI 1.10–36.04) and 11.78 (95% CI 1.25–111.38). Significant association was not demonstrated in AHI and the Framingham CVD risk.ConclusionHigher SBII was associated with an increased 10-year CVD risk after adjusting for multiple potential confounding factors. Additional valuable information derived from polysomnography besides AHI deserves to be paid more attention.

Abstract 12484: Weekday 16:8 Time-Restricted Eating in Breast Cancer Survivors: Feasibility, Safety, and Effects on Cardiometabolic Health

Introduction: Time-restricted eating (TRE) is a form of intermittent fasting involving ad libitum energy intake within a set time window, commonly 8 hours, followed by a water-only fast for 16 hours (i.e., 16:8 TRE). TRE is a practical approach to improve cardiometabolic health but has not been tested in cancer populations. Hypothesis: TRE is feasible (>85% adherence), safe (no major adverse events), and will improve cardiometabolic health in breast cancer survivors. Methods: Women who completed chemotherapy for early-stage breast cancer 1-6 years earlier, are ≥60 years, have a BMI >25 kg/m 2 , and not taking lipid or glucose-lowering medications were enrolled in a single-arm study of 16:8 TRE on weekdays for 8 weeks. Participants could eat ad libitum between 12-8 pm on weekdays and all weekend. No other dietary or physical activity instructions were given. Adherence was collected by twice daily text messages that asked participants to respond with the times that they started/stopped eating. The Framingham 10-year cardiovascular disease (CVD) risk score and heart age, and ectopic adipose tissue (3T magnetic resonance imaging) were assessed before and after 8 weeks of TRE. Results: Fifteen participants (66±4 years, 31±4 kg/m 2 ) have completed the study. Participants responded to 99% of text messages and adhered to the 16-hour fast a median of 98% of days (range 93-100%). Reported symptoms were minor and transient. At baseline, 73% of participants were at ‘intermediate’ (10-19%) CVD risk, and pharmacological treatment was indicated. Among those at intermediate risk, 8 weeks of TRE decreased the absolute CVD risk by a median of 2% and heart age by 6 years, and reversed the need for pharmacological treatment (i.e., reclassification to ‘low’ risk) or metabolic syndrome in 45%. In all participants, visceral adipose tissue decreased by a median of 6% (p=0.018) and triglycerides by 17% (p=0.008). There were no significant changes in hemoglobin A1c, or ectopic adipose tissue in the liver or thigh. Conclusions: Eight weeks of weekday 16:8 TRE is highly feasible, safe, and reduces CVD risk among older breast cancer survivors with overweight/obesity at moderate CVD risk. Improvements in glucose control and liver/thigh ectopic adipose tissue may require a longer intervention.

A lower value for quantitative ultrasound at radius is an additional indicator of metabolic syndrome and cardiovascular disease risk

The relationships between quantitative ultrasound (QUS) values, metabolic syndrome (MetS) and cardiovascular disease (CVD) risk are unclear. Objective The objective was to determine the relationships between QUS and MetS as well as CVD risk. This was a cross-sectional study conducted in Shanghai, China. One-thousand four hundred and thirty-nine Chinese women and men with or without MetS were studied. Speed of sound (SOS) at radius, phalanx and tibia and their relationships with MetS and Framingham's 10-year cardiovascular disease risk scores were investigated. Premenopausal women with MetS had significant lower SOS at radius than those without MetS after adjusting for age, BMI and fat mass percentage (P = 0·02). The radius SOS was negatively associated with waist circumference (r = -0·109, P = 0·025), waist-to-hip ratio (r = -0·124, P = 0·01) and 2 h postprandial glucose level (r = -0·125, P = 0·012) in premenopausal women. Waist circumference, waist-to-hip ratio and 2 h postprandial glucose level increased with the decreasing tertiles of radius SOS after adjustment of age (P = 0·003, 0·002 and 0·008, respectively). The CVD risk increased with decreasing tertiles of radius SOS in postmenopausal women even after the adjustment of age, years since menopause, MetS components, smoking and alcohol habits (P < 0·001), but not in premenopausal women and men. Lower radius SOS is associated with greater risks of MetS and CVD in premenopausal and postmenopausal women, respectively. The QUS value derived from non-weight-bearing site, such as radius, may represent an additional indicator of MetS and CVD risk in women.