Sleep Disorders Linked to Increased Risk of Aortic Stenosis, finds study
Researchers have discovered in a new study that people with sleep disorders have a greater risk of developing aortic stenosis (AS), independent of traditional cardiovascular risk factors. Using two large electronic health record (EHR) databases, the TriNetX network and the All of Us study, researchers investigated the long-term implications of sleep disorders on heart valve disease. Biochemical measurements indicated that alterations in a patient's lipid profile were a mediating factor in this association. The study was published in the American Journal of Preventive Cardiology by Nadim El Jamal and colleagues.
This study was to determine whether sleep disorders would be associated with subsequent development of aortic stenosis by analyzing patient data from large scale, EHR databases. Cox proportional hazards models were constructed to identify the strength of the association. In addition to the analysis of EHR data, the investigators examined select biochemicals to consider potential biologic explanation of their findings.
The investigators conducted a longitudinal investigation of patients diagnosed with sleep disorders to evaluate risk of developing AS. Cox proportional hazards were constructed to estimate risk, and controlled for confounding cardiovascular risk factors including history of hypertension, diabetes, and obesity. The investigators examined biochemical measurements to identify metabolic alterations, particularly changes in lipid profile, that could mediate the associations between sleep disorders and AS.
Key Findings
•Sleep disorders were significantly associated with increased risk of AS, with a hazard ratio (HR) of 1.15 (95% confidence interval [CI]: 1.13–1.18).
• The risk of AS remained elevated beyond conventional cardiovascular risk factors, suggesting an independent association.
• Changes in lipid metabolism were found to be a primary mediator of increased AS risk.
• The study suggests that disrupted sleep may contribute to cardiovascular pathophysiology, beyond their established effects on hypertension and arrhythmias.
This study provides compelling evidence that sleep disorders are associated with a higher risk of aortic stenosis independent of traditional cardiovascular risk factors, and confirms the role of lipid metabolism in mediating that association which presents a potential strategy for prevention and atrial fibrillation treatment. Addressing sleep disorders should be an important step toward reducing the burden of AS and improving overall cardiovascular health.
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