Sleep Patterns and Traditional Cardiovascular Health Metrics: Joint Impact on Major Adverse Cardiovascular Events in a Prospective Cohort Study

Apr 30, 2024Journal of the American Heart Association

How Sleep Patterns and Heart Health Measures Together Relate to Serious Heart Problems

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Abstract

Over a mean follow-up of 12.73 years, 9,253 participants experienced incident major adverse cardiovascular events (MACE).

Individuals with both a healthy sleep pattern and ideal cardiovascular health (CVH) levels had the lowest MACE risk.
A hazard ratio of 0.306 indicates that optimal sleep and CVH significantly lowers the incidence of MACE.
Elevated CVH scores were linked to a reduced risk of MACE across various sleep patterns.
Similar associations were observed for individual components of MACE, including heart failure and all-cause mortality.
The findings suggest a need to consider both sleep health and CVH in strategies to reduce cardiovascular disease risk.

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BACKGROUND: This study examines the association between traditional cardiovascular health (CVH) metrics and major adverse cardiovascular events (MACE) incidence in individuals with diverse sleep patterns.

METHODS AND RESULTS: We analyzed data from 208 621 participants initially free of cardiovascular disease (CVD) in the UK Biobank study. Sleep patterns were assessed using scores for chronotype, duration, insomnia, snoring, and daytime dozing. Traditional CVH scores were derived from the Life's Simple 7 metrics. Cox proportional hazards multivariate regression assessed associations between distinct combinations of CVH and sleep scores and MACE, including nonfatal myocardial infarction, nonfatal stroke, and CVD mortality. Over a mean follow-up of 12.73 years, 9253 participants experienced incident MACE. Individuals with both a healthy sleep pattern and ideal CVH levels had the lowest MACE risk compared with those with a poor sleep pattern and poor CVH levels (hazard ratio, 0.306 [95% CI, 0.257-0.365];<0.001). Elevated CVH scores were associated with a reduced risk of MACE across different sleep patterns. Similar trends were observed for individual MACE components, heart failure, and all-cause mortality. These findings remained robust in sensitivity analyses and across various subgroups. P

CONCLUSIONS: In individuals without known CVD, maintaining a favorable sleep pattern and achieving optimal CVH levels, as measured by traditional metrics, were associated with the lowest MACE risk. Enhanced CVH significantly reduced CVD risk, even in individuals with a poor sleep pattern. These results emphasize the importance of considering multiple dimensions of sleep health alongside CVH to mitigate CVD risk.

REGISTRATION: URL: https://www.ukbiobank.ac.uk; Unique identifier: 91090.

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Sleep Patterns and Traditional Cardiovascular Health Metrics: Joint Impact on Major Adverse Cardiovascular Events in a Prospective Cohort Study

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