Snoring and risk of cardiovascular disease in women

OBJECTIVES To examine prospectively the association between snoring and inc idence of cardiovascular disease (CVD) in women. BACKGROUND Whether snoring increases risk of CVD remains unclear; most prev ious studies have been small, not prospective and limited to men. METHODS Seventy-one thousand seven hundred seventy nine female nurses 40 th rough 65 years of age and without previously diagnosed CVD or cancer at bas eline in 1986 were followed up for eight years. Frequency of snoring was as sessed using mailed questionnaires at baseline. RESULTS During eight pears of follow-up, we documented 1,042 incident cases of major CVD events (644 coronary heart disease [CHD] and 398 stroke). Com pared with nonsnorers, the age-adjusted relative risks (RRs) of CVD were 1. 46 (95% confidence interval 1.23 to 1.74) for occasional snorers and 2.02 ( 1.62 to 2.53) for regular snorers. The age-adjusted RRs of CHD were 1.43 (1 .15 to 1.77) for occasional snorers and 2.18 (1.65 to 2.87) for regular sno rers. The age-adjusted RRs of stroke were 1.60 (1.21 to 2.12) and 1.88 (1.2 9 to 2.74), respectively After further adjustment for smoking, body mass in dex (BMI) and other covariates, the positive association between snoring an d CVD was attenuated but remained statistically significant (RRs of CVD wer e 1.20 [1.01 to 1.43] for occasional snorers and 1.33 [1.06-1.67] for regul ar snorers. CONCLUSIONS These data suggested that snoring is associated with a modest b ut significantly increased risk of CVD in women, independent of age, smokin g, BMI and other cardiovascular risk factors. While further study is needed to elucidate the biological mechanism underlying this association, snoring may help clinicians identify individuals at higher risk for CVD. (J Am Col l Cardiol 2000;35:308-13) (C) 2000 by the American College of Cardiology.