Insomnia symptom trajectories and incident cardiovascular disease in older adults: a longitudinal cohort study.

IF 5.1 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Heart Pub Date : 2025-05-27 DOI:10.1136/heartjnl-2024-325362
Qing-Mei Huang, Hao-Yu Yan, Huan Chen, Jia-Hao Xie, Jian Gao, Zhi-Hao Li, Chen Mao
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引用次数: 0

Abstract

Background: Insomnia symptoms are prevalent in older adults and linked to cardiovascular disease (CVD), but the role of long-term symptom trajectories remains unclear. We investigated associations between insomnia symptoms, their trajectories over time and incident CVD in a population-based cohort.

Methods: This longitudinal study included 12 102 participants aged ≥50 years without baseline CVD from the US Health and Retirement Study (2002-2018). Insomnia symptoms (non-restorative sleep, difficulty initiating/maintaining sleep, early awakening) were assessed at baseline; trajectories were modelled over 4 years (2002-2006) using latent class analysis. Cox models estimated HRs for incident CVD (heart disease or stroke), adjusted for sociodemographics, lifestyle and comorbidities.

Results: During a median of 10.2-year follow-up, 3962 incident CVD events occurred. Compared with no symptoms, participants with one, two, or three to four symptoms had higher CVD risk (HR 1.16, 95% CI 1.05 to 1.27; HR 1.16, 95% CI 1.05 to 1.28; HR 1.26, 95% CI 1.15 to 1.38, respectively). Four trajectories were identified: persistent low (56.3%), decreasing (27.1%), increasing (7.2%) and persistent high (9.5%). Compared with persistent low, increasing (HR 1.28, 95% CI 1.10 to 1.50) and persistent high (HR 1.32, 95% CI 1.15 to 1.50) trajectories were associated with elevated CVD risk.

Conclusions: Greater burden of insomnia symptoms at baseline and trajectories over time were associated with higher CVD incidence in older adults.

老年人失眠症状轨迹和心血管疾病:一项纵向队列研究
背景:失眠症状在老年人中普遍存在,并与心血管疾病(CVD)有关,但长期症状轨迹的作用尚不清楚。我们在以人群为基础的队列中调查了失眠症状及其随时间变化的轨迹与CVD事件之间的关系。方法:这项纵向研究纳入了来自美国健康与退休研究(2002-2018)的12102名年龄≥50岁、无基线心血管疾病的参与者。在基线时评估失眠症状(非恢复性睡眠、难以开始/维持睡眠、早醒);使用潜在类别分析对4年(2002-2006)的轨迹进行建模。Cox模型估计了CVD(心脏病或中风)事件的hr,并根据社会人口统计学、生活方式和合并症进行了调整。结果:在中位10.2年的随访期间,发生了3962例CVD事件。与没有症状的受试者相比,有一种、两种或三到四种症状的受试者有更高的心血管疾病风险(HR 1.16, 95% CI 1.05 ~ 1.27;HR 1.16, 95% CI 1.05 ~ 1.28;HR 1.26, 95% CI 1.15 ~ 1.38)。确定了四种轨迹:持续低(56.3%)、下降(27.1%)、上升(7.2%)和持续高(9.5%)。与持续低相比,增加(HR 1.28, 95% CI 1.10至1.50)和持续高(HR 1.32, 95% CI 1.15至1.50)的轨迹与CVD风险升高相关。结论:更大的基线失眠症状负担和随时间的发展轨迹与老年人更高的CVD发病率相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Heart
Heart 医学-心血管系统
CiteScore
10.30
自引率
5.30%
发文量
320
审稿时长
3-6 weeks
期刊介绍: Heart is an international peer reviewed journal that keeps cardiologists up to date with important research advances in cardiovascular disease. New scientific developments are highlighted in editorials and put in context with concise review articles. There is one free Editor’s Choice article in each issue, with open access options available to authors for all articles. Education in Heart articles provide a comprehensive, continuously updated, cardiology curriculum.
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