{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:25:04Z","timestamp":1790713504147,"version":"4.1.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,3,29]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Prospective data suggest that sleep-disordered breathing enhances risk for incident and recurrent cardiovascular disease (CVD). However, a reverse causal pathway whereby incident CVD causes or worsens sleep-disordered breathing has not been studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      A total of 2721 Sleep Heart Health Study participants (mean age 62, standard deviation=10 years; 57% women; 23% minority) without CVD at baseline underwent 2 polysomnograms 5 years apart. Incident CVD events, including myocardial infarction, congestive heart failure, and stroke, were ascertained and adjudicated. The relation of incident CVD to change in apnea-hypopnea index between the 2 polysomnograms was tested with general linear models, with adjustment for age, sex, race, study center, history of diabetes mellitus, change in body mass index, change in neck circumference, percent sleep time spent in supine sleep, and time between the 2 polysomnograms. Incident CVD occurred in 95 participants between the first and second polysomnograms. Compared with participants without incident CVD, those with incident CVD experienced larger increases in apnea-hypopnea index between polysomnograms. The difference in adjusted mean apnea-hypopnea index change between subjects with and without incident CVD was 2.75 events per hour (95% confidence interval, 0.26 to 5.24;\n                      <jats:italic>P<\/jats:italic>\n                      =0.032). This association persisted after subjects with central sleep apnea were excluded. Compared with participants without incident CVD, participants with incident CVD had greater increases in both mean obstructive and central apnea indices, by 1.75 events per hour (95% confidence interval, 0.10 to 1.75;\n                      <jats:italic>P<\/jats:italic>\n                      =0.04) and by 1.07 events per hour (95% confidence interval, 0.40 to 1.74;\n                      <jats:italic>P<\/jats:italic>\n                      =0.001), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>In a diverse, community-based sample of middle-aged and older adults, incident CVD was associated with worsening sleep-disordered breathing over 5 years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.110.974022","type":"journal-article","created":{"date-parts":[[2011,3,15]],"date-time":"2011-03-15T14:18:41Z","timestamp":1300198721000},"page":"1280-1286","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":103,"title":["Association of Incident Cardiovascular Disease With Progression of Sleep-Disordered Breathing"],"prefix":"10.1161","volume":"123","author":[{"given":"Hassan A.","family":"Chami","sequence":"first","affiliation":[{"name":"From the Department of Medicine, Boston University School of Medicine, Boston, MA (H.A.C., D.J.G.); Veterans Affairs Boston Healthcare System, West Roxbury, MA (H.A.C., D.J.G.); American Association of Homes and Services for the Aging, Washington, DC (H.E.R.); Department of Medicine, Georgetown University, Washington, DC (H.E.R.); Division of Sleep Medicine, Harvard Medical School, Boston, MA (S.F.Q.); and Arizona Respiratory Center, University of Arizona, Tucson (S.F.Q.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helaine E.","family":"Resnick","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Boston University School of Medicine, Boston, MA (H.A.C., D.J.G.); Veterans Affairs Boston Healthcare System, West Roxbury, MA (H.A.C., D.J.G.); American Association of Homes and Services for the Aging, Washington, DC (H.E.R.); Department of Medicine, Georgetown University, Washington, DC (H.E.R.); Division of Sleep Medicine, Harvard Medical School, Boston, MA (S.F.Q.); and Arizona Respiratory Center, University of Arizona, Tucson (S.F.Q.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart F.","family":"Quan","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Boston University School of Medicine, Boston, MA (H.A.C., D.J.G.); Veterans Affairs Boston Healthcare System, West Roxbury, MA (H.A.C., D.J.G.); American Association of Homes and Services for the Aging, Washington, DC (H.E.R.); Department of Medicine, Georgetown University, Washington, DC (H.E.R.); Division of Sleep Medicine, Harvard Medical School, Boston, MA (S.F.Q.); and Arizona Respiratory Center, University of Arizona, Tucson (S.F.Q.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Boston University School of Medicine, Boston, MA (H.A.C., D.J.G.); Veterans Affairs Boston Healthcare System, West Roxbury, MA (H.A.C., D.J.G.); American Association of Homes and Services for the Aging, Washington, DC (H.E.R.); Department of Medicine, Georgetown University, Washington, DC (H.E.R.); Division of Sleep Medicine, Harvard Medical School, Boston, MA (S.F.Q.); and Arizona Respiratory Center, University of Arizona, Tucson (S.F.Q.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.8.893"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.20.2408"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.1.2001008"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.82.5.548"},{"key":"e_1_3_4_6_2","first-page":"283","article-title":"Is obstructive sleep apnea a risk factor for myocardial infarction and cardiac arrhythmias in patients with coronary heart disease?","volume":"19","author":"Koehler U","year":"1996","unstructured":"Koehler U, Schafer H. Is obstructive sleep apnea a risk factor for myocardial infarction and cardiac arrhythmias in patients with coronary heart disease? Sleep. 1996; 19: 283\u2013 286.","journal-title":"Sleep"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00019501-199607000-00009"},{"key":"e_1_3_4_8_2","first-page":"345","article-title":"Obstructive sleep apnea in patients with coronary artery disease","volume":"146","author":"Sanner B","year":"1996","unstructured":"Sanner B, Konermann M, Weiss T, Kreuzer I, Laschewski F, Burman-Urbaneck M, Sturm A. Obstructive sleep apnea in patients with coronary artery disease. Wiener Med Wochenschrift. 1996; 146: 345\u2013 347.","journal-title":"Wiener Med Wochenschrift"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)91799-G"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199107000-00019"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(96)00122-2"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-5231(05)70435-4"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200412-1631SO"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2105124"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)74229-X"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.6.2076"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200611-1588OC"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200404-510OC"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2004.072371"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.5.2007013"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1999.86.4.1264"},{"key":"e_1_3_4_22_2","first-page":"985","article-title":"A mechanism of central sleep apnea in patients with heart failure","volume":"23","author":"Javaheri S","year":"1999","unstructured":"Javaheri S. A mechanism of central sleep apnea in patients with heart failure. N Engl J Med. 1999; 23: 985\u2013 987.","journal-title":"N Engl J Med"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00214502"},{"key":"e_1_3_4_24_2","first-page":"1077","article-title":"The Sleep Heart Health Study: design, rationale, and methods","volume":"20","author":"Quan SF","year":"1997","unstructured":"Quan SF, Howard BV, Iber C, Kiley JP, Nieto FJ, O'Connor GT, Rapoport DM, Redline S, Robbins J, Samet JM, Wahl PW. The Sleep Heart Health Study: design, rationale, and methods. Sleep. 1997; 20: 1077\u2013 1085.","journal-title":"Sleep"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/21.7.759"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/21.7.749"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/25.8.8"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(03)00055-6"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.11.061"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009019"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/1047-2797(91)90005-W"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/1047-2797(93)90105-D"},{"key":"e_1_3_4_33_2","volume-title":"The Framingham Heart Study: An Epidemiological Investigation of Cardiovascular Disease","author":"Cupples LA","year":"1987","unstructured":"Cupples LA, D'Agostino RB. Some risk factors related to the annual incidence of cardiovascular disease and death using pooled repeated biennial measurements: Framingham Study, 30-year follow-up. In: , Kannel WB, Polf PA, Garrison RJ eds. The Framingham Heart Study: An Epidemiological Investigation of Cardiovascular Disease. Washington, DC: US Government Printing Office; 1987. NIH publication 87-203."},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009406"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.902452"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.110.974022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:00:01Z","timestamp":1715565601000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.110.974022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,3,29]]},"references-count":34,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2011,3,29]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.110.974022"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.110.974022","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.10830957.11741061","asserted-by":"object"}]},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,3,29]]},"assertion":[{"value":"2010-06-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-01-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-03-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}