Table 2.
Multivariable Cox Regression Analysis for Nonfatal CVD and Cardiovascular and All-Cause Mortality in the SHHS
| ΔHR Categories | Nonfatal CVD* [Hazard Ratio (95% CI)] | CVD Mortality [Hazard Ratio (95% CI)] | All-Cause Mortality [Hazard Ratio (95% CI)] |
|---|---|---|---|
| All subjects (N = 4,575) | |||
| Midrange | 1.00 | 1.00 | 1.00 |
| Low | 1.07 (0.90–1.27) | 1.21 (0.94–1.54) | 1.26 (1.10–1.44)† |
| High | 1.60 (1.28–2.00)† | 1.68 (1.22–2.30)‡ | 1.29 (1.07–1.55)‡ |
| AHI ⩾ 15 events/h (N = 2,148) | |||
| Midrange | 1.00 | 1.00 | 1.00 |
| Low | 1.13 (0.90–1.43) | 1.39 (1.00–1.93) | 1.13 (0.94–1.36) |
| High | 1.69 (1.28–2.22)† | 1.92 (1.29–2.86)‡ | 1.36 (1.09–1.71)‡ |
| AHI < 15 events/h (N = 2,427) | |||
| Midrange | 1.00 | 1.00 | 1.00 |
| Low | 0.97 (0.75–1.25) | 0.98 (0.67–1.42) | 1.40 (1.14–1.71)‡ |
| High | 1.60 (1.06–2.39)§ | 1.28 (0.73–2.22) | 1.08 (0.75–1.55) |
| AHI ⩾ 30 events/h (N = 820) | |||
| Midrange | 1.00 | 1.00 | 1.00 |
| Low | 1.40 (0.95–2.04) | 2.09 (1.17–3.74)§ | 1.11 (0.82–1.51) |
| High | 1.90 (1.28–2.80)‡ | 2.96 (1.60–5.48)† | 1.51 (1.10–2.07)§ |
| AHI < 30 events/h (N = 3,755) | |||
| Midrange | 1.00 | 1.00 | 1.00 |
| Low | 1.01 (0.83–1.23) | 1.06 (0.81–1.39) | 1.29 (1.11–1.50)† |
| High | 1.51 (1.13–2.00)‡ | 1.38 (0.93–2.03) | 1.16 (0.91–1.48) |
| HB ⩾ 62%min/h (N = 1,138) | |||
| Midrange | 1.00 | 1.00 | 1.00 |
| Low | 1.38 (1.00–1.89)§ | 1.89 (1.19–3.00)‡ | 1.44 (1.13–1.83)‡ |
| High | 1.93 (1.36–2.73)† | 3.50 (2.15–5.71)† | 1.84 (1.40–2.40)† |
| HB < 62%min/h (N = 3,409) | |||
| Midrange | 1.00 | 1.00 | 1.00 |
| Low | 0.96 (0.78–1.17) | 0.94 (0.70–1.26) | 1.17 (1.00–1.38) |
| High | 1.35 (0.99–1.84) | 0.93 (0.58–1.50) | 0.89 (0.66–1.18) |
Definition of abbreviations: AHI = apnea–hypopnea index; CI = confidence interval; CVD = cardiovascular disease; ΔHR = pulse-rate response to apneas/hypopneas; HB = sleep-apnea–specific hypoxic burden; SHHS = Sleep Heart Health Study.
All models were adjusted for age, sex, race, body mass index, smoking, diabetes, hypertension, lipid-lowering medication, β-blockers, baseline CVD, event-related minimum pulse rate, and AHI. Bold indicates statistical significance at the level indicated by the footnote symbol.
The number of participants in nonfatal CVD analysis is lower than reported for CVD and all-cause mortality because of exclusion of fatal CVD events from the analysis. A test of interaction was only significant for the interaction between high ΔHR and HB categories.
P < 0.001.
P < 0.01.
P < 0.05.