Sleep Apnea Is Independently Associated With Peripheral Arterial Disease in the Hispanic Community Health Study/Study of Latinos

Background: Compared to non-Hispanic Whites, Hispanic Americans have a significantly lower prevalence of peripheral arterial disease (PAD). Since Hispanic ethnicity in the United States is heterogeneous, the purpose of this study was to determine the differential odds for PAD by Hispanic/Latino subgroup. Methods: Subjects were 9,648 men and women over the age of 45 years enrolled in the Hispanic Community Health Study - Study of Latinos (HCHS-SOL) who were evaluated by extensive survey information, relevant physical measurements and fasting blood assays. The ankle brachial index (ABI) was computed as the higher of the posterior tibial and dorsalis pedis systolic blood pressures (SBP) for each leg divided by the higher brachial artery SBP. The index ABI was the lower of the two. An ABI ≤ 0.90 was criterion for the presence of PAD. Results: The mean age was 56 years and 62% were female. Thirty percent were Mexican American, while 27% were Cuban American, 19% Puerto Rican American, 9% Dominican American, 7% Central American, 5% South American and 3% Mixed or Other Hispanic ethnicities. Overall, the prevalence of an ABI ≤ 0.90 (PAD), 0.90 to 0.99 (borderline), 1.0 to 1.39 (normal) and ≥ 1.40 (high) was 5.7, 19.3, 72.5 and 2.6%, respectively. Cuban Americans had the highest prevalence of PAD (9.1%), followed by Puerto Rican (5.9%), Central American (5.3%), Mixed/Other (5.0%), Dominican (4.7%), South American (4.6%) and Mexican Americans (3.2%). The prevalence of an ABI ≥ 1.40 ranged from 3.1% (South Americans) to 0.6% (Mixed/Other). After multivariable adjustment, and compared to Mexican Americans, Cuban Americans had nearly a 3-fold higher odds for PAD (OR = 2.85). The odds of PAD for the other Hispanic/Latino groups ranged from 1.23 to 1.82. Although males had over a 3-fold higher odds of an ABI ≥ 1.40 (OR = 3.55), the odds did not differ significantly by Hispanic/Latino ethnicity. Conclusions: Compared to Mexican Americans, all other Hispanic/Latino ethnic groups have a significantly higher odds of having PAD, with the odds being nearly 3-fold higher among Cuban Americans.

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Cerebral hemodynamics in sleep apnea and actigraphy-determined sleep duration in a sample of the Hispanic community health study: study of Latinos

Sleep Medicine ◽

10.1016/j.sleep.2017.11.807 ◽

2017 ◽

Vol 40 ◽

pp. e275-e276

Author(s):

D. Yang ◽

T. Rundek ◽

S. Patel ◽

D. Cabral ◽

S. Redline ◽

...

Keyword(s):

Sleep Apnea ◽

Community Health ◽

Sleep Duration ◽

Cerebral Hemodynamics ◽

Health Study ◽

Hispanic Community

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Association of Body Mass Index with Peripheral Arterial Disease in Older Adults: The Cardiovascular Health Study

Yearbook of Vascular Surgery ◽

10.1016/j.yvas.2012.01.004 ◽

2012 ◽

Vol 2012 ◽

pp. 31-32

Author(s):

G.L. Moneta

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Peripheral Arterial Disease ◽

Body Mass ◽

Cardiovascular Health ◽

Arterial Disease ◽

Health Study ◽

Cardiovascular Health Study ◽

Peripheral Arterial

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Sleep Apnea Is Associated with Hearing Impairment: The Hispanic Community Health Study/Study of Latinos

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.5804 ◽

2016 ◽

Vol 12 (05) ◽

pp. 719-726 ◽

Cited By ~ 9

Author(s):

Amit Chopra ◽

Molly Jung ◽

Robert C. Kaplan ◽

David W. Appel ◽

Elizabeth A. Dinces ◽

...

Keyword(s):

Sleep Apnea ◽

Community Health ◽

Hearing Impairment ◽

Health Study ◽

Hispanic Community

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Peripheral Arterial Disease Screening Within a Hispanic Community

Journal of Vascular Nursing ◽

10.1016/j.jvn.2014.05.013 ◽

2014 ◽

Vol 32 (2) ◽

pp. 75

Author(s):

Kathleen M. Large ◽

M. Eileen Walsh

Keyword(s):

Peripheral Arterial Disease ◽

Arterial Disease ◽

Disease Screening ◽

Hispanic Community ◽

Peripheral Arterial

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0607 Clinical Phenotypes of OSA in Diverse Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos

SLEEP ◽

10.1093/sleep/zsaa056.604 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A232-A232

Author(s):

K T Gonzalez ◽

W Tarraf ◽

D M Wallace ◽

A Stickel ◽

N Schneiderman ◽

...

Keyword(s):

Sleep Apnea ◽

Community Health ◽

Latent Class ◽

Health Resources ◽

Health Study ◽

Clinical Samples ◽

Apnea Hypopnea Index ◽

Fit Statistics ◽

Hispanic Community ◽

Obstructive Sleep

Abstract Introduction Recent work on US non-Latino Whites and Europeans from clinical samples used obstructive sleep apnea (OSA) symptoms to generate OSA phenotypes for individuals with moderate-severe OSA and proposed between 3-5 clusters. Validating these clusters in a diverse Hispanic/Latino community-based population with different biopsychosocial characteristics is crucial for early OSA identification and more personalized treatment. Methods This work is based on baseline data from The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). HCHS/SOL is a prospective cohort study designed using a multisite (Bronx, NY, Chicago, IL, Miami, FL, San Diego, CA) multistage probability sample. The subpopulation of interest included adults 18-74 years (unweighted n=1,623) meeting criteria for moderate-severe OSA symptoms (≥15 Apnea-Hypopnea index (AHI) events per hour). We performed latent class analysis (LCA) using 15 common OSA symptoms to identify phenotype clusters. Results Average age was 52.4 ± 13.9 years and 34.1% were female. Mean AHI was 33.8 ± 22.5 events per hour. Fit statistics and clinical significance suggested that a three-class solution provided best fit to the data. The symptom profiles were consistent with (1) a Minimally Symptomatic group (46.8%), (2) a Disturbed Sleep group (38.1%), and (3) a Daytime Sleepiness group (15.1%). Validation analyses using alternative hierarchical and partitioning algorithms also suggested support for a three-class solution. Conclusion Sleep apnea phenotypes among diverse Hispanics/Latinos were consistent with recent findings from the Sleep Apnea Global Interdisciplinary Consortium. However, we found notable differences in the prevalence of these clusters relative to Whites. This suggests that other biopsychosocial factors may be contributing to OSA phenotypes among Hispanics/Latinos. Identification of OSA phenotypes in Hispanics/Latinos could inform better sleep interventions and therapeutics and help better align public health resources. Support 5R01AG048642-05; R21AG056952; R21HL140437.

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Abstract 3113: Uncontrolled Hypertension, Systolic and Diastolic Blood Pressure and Development of Symptomatic Peripheral Arterial Disease in the Women’s Health Study

Circulation ◽

10.1161/circ.116.suppl_16.ii_698-a ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Tiffany M Powell ◽

Robert J Glynn ◽

Mark A Creager ◽

Paul M Ridker ◽

Aruna D Pradhan

Keyword(s):

Blood Pressure ◽

Peripheral Arterial Disease ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Arterial Disease ◽

Uncontrolled Hypertension ◽

Health Study ◽

Adjusted Risk ◽

Treatment Status ◽

Peripheral Arterial

Background : Prospective data pertaining to risk factors for peripheral arterial disease (PAD) in women are sparse. Few studies have evaluated blood pressure, including uncontrolled hypertension, and PAD onset in women. Methods and Results : We examined the relationship between blood pressure and development of confirmed symptomatic PAD (n=116 events) in a prospective cohort study of 39,261 female health professionals aged ≤ 45 years without diagnosed vascular disease at baseline. Median follow-up was 11.4 years. Women were first grouped according to baseline presence of uncontrolled hypertension, defined as reported systolic blood pressure (SBP)≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg, and pharmacologic treatment status. SBP and DBP were then modeled as continuous and categorical exposures irrespective of treatment status. Pulse pressure (PP) and mean arterial pressure (MAP) were also assessed. Age-adjusted and multivariable-adjusted risk estimates were derived from Cox proportional hazards models. Women with treated but uncontrolled hypertension had the highest risk of symptomatic PAD (0.67 events per 1000 person-years). Adjusted hazard ratios (HRs) compared to women without hypertension were 1.1 (95% CI, 0.5–2.3) for women who were treated and controlled, 1.7 (95% CI, 1.0 –3.0) for women untreated and uncontrolled, and 2.3 (95% CI, 1.4 – 4.0) for women treated and uncontrolled (p-trend<0.001). When hypertension was examined using continuous and categorical measures, there was a 33% increase in risk per 10 mmHg of SBP (95% CI, 18 to 47%) and a positive gradient in multivariable-adjusted risk according to SBP category (<120, 120 –139, 140 –159, and ≤ 160 mmHg); HRs were 1.0, 1.6, 2.8, and 4.3 (p-trend<0.001), respectively. We also considered DBP, PP, and MAP. While individually predictive, none was a stronger predictor than SBP with none adding predictive ability beyond SBP. Conclusions : Uncontrolled hypertension is associated with incident symptomatic PAD in women. Among blood pressure variables assessed, SBP is the best single predictor. These data support a strong prognostic role for systolic blood pressure in the development of peripheral atherosclerosis in women.

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