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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eight studies that examined the relation between snoring and vascular disease were identified. The prevalence of habitual snoring, measured by questionnaire or interview, varied from 3% to 29% of adults and was dependent on age, sex, obesity, and smoking habit. In men, habitual snoring was associated with hypertension and ischaemic heart disease, with adjusted relative risks in the range 1.3-2.0. For women, only one study provided adjusted estimates of relative risk, which were 2.8 for hypertension and 1.2 for angina. Adequately adjusted relative risks for cerebrovascular disease have not been reported, but unadjusted estimates varied from 1.6 to 10.3. These studies had several limitations, including the lack of a standard definition of snoring, the use of unvalidated questionnaires, and failure to account for confounding variables and the possibility of reporting bias. Only one study was prospective. Epidemiological criteria for a causal association between snoring and vascular disease have not been satisfied. The apparent excess risk is probably due to the consequences of sleep apnoea rather than snoring itself.
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PMID:Is snoring a cause of vascular disease? An epidemiological review. 256 56

The association of snoring with hypertension and ischaemic heart disease (IHD) was tested by postal questionnaire in a population of 3847 men and 3664 women aged 40-69 years. Hypertension associated highly significantly with snoring, the relative risk (RR) of hypertension between habitual snorers and never snorers being 1.94 in men and 3.19 in women. This association was also found when adjusting for body-mass index. A significant association between angina pectoris and habitual snoring was observed in men (RR = 2.22). In women the relative risk was not significant. An association between habitual snoring and angina pectoris in men was also found after adjusting for hypertension and body-mass index (RR = 2.01, p less than 0.01). The relative risks for myocardial infarction and hospital admission for IHD for habitual snorers were non-significant.
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PMID:Snoring as a risk factor for hypertension and angina pectoris. 285 45

The association of snoring with ischaemic heart disease and stroke was studied prospectively in 4388 men aged 40-69. The men were asked, in a questionnaire sent to them, whether they snored habitually, frequently, occasionally, or never. Hospital records and death certificates were checked for the next three years to establish how many of the men developed ischaemic heart disease or stroke: the numbers were 149 and 42, respectively. Three categories of snoring were used for analysis: habitual and frequent snorers (n = 1294), occasional snorers (n = 2614), and non-snorers (n = 480). The age adjusted relative risk of ischaemic heart disease between habitual plus frequent snorers and non-snorers was 1.91 (p less than 0.01) and for ischaemic heart disease or stroke, or both, 2.38 (p less than 0.001). There were no cases of stroke among the non-snorers. Adjustment for age, body mass index, history of hypertension, smoking, and alcohol use did not significantly decrease the relative risks, which were 1.71 (p greater than 0.05) for ischaemic heart disease and 2.08 (p less than 0.01) for ischaemic heart disease and stroke combined. At the beginning of follow up in 1981, 462 men reported a history of angina pectoris or myocardial infarction. For them the relative risk of ischaemic heart disease between habitual plus frequent snorers and non-snorers was 1.30 (NS); for men without previous ischaemic heart disease 2.72 (p less than 0.05). Snoring seems to be a potential determinant of risk of ischaemic heart disease and stroke.
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PMID:Snoring as a risk factor for ischaemic heart disease and stroke in men. 310 79

We report the association between hostility and the incidence of ischemic heart disease (IHD) in 3,750 Finnish men aged 40-59. Hostility was assessed from self-ratings on irritability, ease of anger-arousal, and argumentativeness, and four groups were formed from the summed hostility ratings. At baseline, the age-adjusted relative risk (RR) of the prevalence of angina pectoris between the highest and lowest hostility groups was 2.88 (95% confidence limits (CL), range 1.71-4.77). A three-year follow-up yielded 65 deaths and 109 IHD-incident cases. Hostility did not predict IHD among healthy men, but among men with previous IHD and hypertension (N = 104), the age-adjusted RR of IHD between the highest and lowest hostility groups was 12.9 (95% CL, 3.92-42.6). After standardization for smoking, obesity, heavy alcohol use, and snoring, the RR was 14.6 (95% CL, 1.94-110). When the degree of dyspnea at baseline was also standardized, the RR was 21.1 (95% CL, 1.59-282). Our data suggest that extreme hostility is not a consequence of symptom severity; rather, hostility is a strong determinant of coronary attack among hypertensive men with IHD.
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PMID:Hostility as a risk factor for mortality and ischemic heart disease in men. 341 67

Men who snore heavily have an increased incidence of hypertension, angina, stroke, and neuropsychologic dysfunction, which may be due to nocturnal oxygen desaturation. Nocturnal oxygen therapy might be beneficial to such individuals by improving oxygenation and relieving tissue hypoxia. Twenty-eight asymptomatic heavy snoring men were recruited for polysomnographic monitoring during sleep. During the first half-night, air was breathed through a nasal cannula, and during the latter half-night, 2 L/min oxygen was administered. Breathing air, 20 subjects demonstrated sleep apneas, hypopneas and nocturnal oxygen desaturation. Eighteen subjects had more than ten apneas plus hypopneas per hour. Thirteen subjects reached low oxygen saturation below 80 percent and eight below 70 percent. Only 13 of the 20 subjects showed improvement with oxygen therapy. Apneas alone were not decreased in frequency and were lengthened with oxygen therapy. Episodes of oxygen desaturation were improved by oxygen therapy and consequently, rates of hypopnea were decreased. Severe sleep apnea, hypopnea and oxygen desaturation are common in asymptomatic male snorers, and oxygen therapy is not always beneficial.
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PMID:Snoring, nocturnal hypoxemia, and the effect of oxygen inhalation. 362 20

Complaints about sleep are extremely common in the elderly, leading to an impression that aging-related sleep problems are virtually normal and benign. However, studies have shown that such complaints as habitual snoring, frequent awakening, nocturnal sweating, and awakening with anxiety, may be signs of genuine sleep disorders. The most prevalent and most serious aging-related sleep disorder is sleep apnea. There is recent evidence of an association between sleep apnea and circulatory disorders, including hypertension, stroke, and angina pectoris, and with reduced life expectancy. The older sleep apnea victim may not complain of daytime sleepiness, the usual symptom in younger patients. Sleep apnea, and several other sleep disorders of the elderly are treatable, once an accurate diagnosis is made. Physicians are urged to make questions about sleep as routine as the taking of blood pressure.
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PMID:Sleep disorders in the elderly: rationale for clinical awareness. 367 42

Four hundred forty-one subjects 34 to 69 yr of age were recruited from a random sample of the community. They answered a questionnaire and were monitored in their homes for sleep-disordered breathing (SDB). This report concerns the association between observed SDB and arterial hypertension and vascular disease. Hypertension was defined as self-report of a diagnosis of hypertension made by a physician, current treatment for hypertension, or a systolic pressure greater than 150 mm Hg or a diastolic pressure greater than 90 mm Hg. Coronary artery disease was defined by self-report of angina or myocardial infarction of "heart attack." There were few cases of stroke or claudication, and a category of "occlusive vascular disease" was defined by self-report of coronary artery disease or of "blocked arteries" or stroke. Subjects were classified as snorers (n = 289) or nonsnorers (n = 73) by self-report of regular snoring, and as having SDB (n = 79) if more than 15 abnormal respiratory events were recorded per hour of recording. There were significant increases in the prevalence of hypertension, coronary artery disease, and occlusive vascular disease from nonsnorers (26, 7, and 10%, respectively) through snorers (39, 12, and 17%) to subjects with SDB (57, 20, and 28%). The crude odds ratio for SDB versus nonsnorers was 3.8 (95% CI, 1.9 to 7.5) for hypertension, 3.5 (1.2 to 10.0) for coronary artery disease, and 3.7 (1.5 to 9.1) for occlusive vascular disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A community study of snoring and sleep-disordered breathing. Health outcomes. 763 32

An epidemiological study of sleep obstruction and its orthodontic consequences is under way on a cohort (500) of 4-year-old children. The parents are asked about the child's snoring, sleep apnea, sucking habits, infections and 'genetic clues'. Dental casts have been made from the first 100 children and the group of children who snore are being compared to the non-snorers. A sleep study, a lateral cephalogram and dental casts are done on all snorers in the cohort. Preliminary results show that 6.2% snore every night by age 4 and another 18% when infected. More children use pacifiers among the snorers than in the non-snoring group (60% vs. 35%). Tonsillar angina is 3 times more common in the snorer group and twice as many of their parents have been adenoidectomized (A) and/or tonsillectomized (T). The dental casts show a significant difference in width of the maxilla and length of the mandible. The children are treated for their breathing obstruction with A or A+T. Two years later, the same cohort will be examined again. The prevalence of snoring and sleep apnea among 4-year-olds will be known as will whether and how treatment for breathing obstruction influences facial development.
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PMID:The epidemiology of sleep related breathing disorder in children. 766 2

As previous studies have suggested an association between obstructive sleep apnea syndrome (OSA) and ischaemic heart disease, the aim of the present study was to evaluate the frequency of clinically relevant OSA in this selected population. From September 1992 to April 1993, 136 patients referred to the Cardiology Unit for suspected angina pectoris were asked to participate in the study. The main inclusion criterion was a stable coronary heart disease, diagnosed by angiography. A sleep questionnaire was administered by a trained physician. Patients who experienced one of the following symptoms: association of body mass index (-weight/height2) above 27.5 and heavy snoring, breathing stops, or daytime hypersomnolence, were selected for a nocturnal oxygen saturation recording. The occurrence of at least one desaturation, defined as a 4% fall from baseline, led to a full night-time polysomnography. One hundred and eight patients (78 males), satisfied the entry criteria. A pulse oximetry was performed in 15, and three patients experienced a significant desaturation. Finally, one patient satisfied the criteria of OSA. The estimated proportion of OSA amounted to 0.92%, in accordance with the prevalence of OSA described in the general population. Clinically relevant OSA does not appear to be more frequent in patients suffering from stable coronary heart disease. Systematic sleep investigations in such patients do not appear to be useful in daily clinical practice.
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PMID:Frequency of obstructive sleep apnoea syndrome detected by means of a questionnaire in patients with coronary heart disease. 854 13

Sleep apnea is associated with many adverse cardiovascular sequelae, including hypertension, nocturnal angina, decreased cardiac output, and bradyarrhythmias. The purpose of this study was to determine if patients referred for pacemaker therapy with asymptomatic bradyarrhythmias have underlying sleep apnea as the etiology of their bradyarrhythmias. This study included eight patients (7 males, 1 female) referred to a cardiac electrophysiology practice for pacemaker therapy. Patients included had asymptomatic bradyarrhythmias that consisted of severe sinus bradycardia, second-degree atrioventricular block, and complete heart block. In 7 of 8 patients, the bradyarrhythmias occurred at night or during the day while asleep. No patients were conditioned athletes. Symptoms often associated with bradyarrhythmias, such as lightheadedness and syncope, were not present. However, seven patients had at least one symptom suggestive of sleep apnea, such as excessive daytime fatigue, snoring, cessation of breathing during sleep (apnea), or frequent night-time awakenings. Overnight polysomnography studies were obtained on patients who had one or more symptoms suggestive of sleep apnea. In this study 7 of 8 patients (88%) referred for pacemaker therapy with asymptomatic bradyarrhythmias were documented by polysomnography to have sleep apnea. When treated with either sleep position modification, nasal continuous positive airway pressure (nasal CPAP), or tracheostomy, all seven patients had improvement in sleep apnea symptoms and remained asymptomatic from their bradyarrhythmias without pacemaker therapy over an average follow-up period of 22 months. One patient without symptoms suggestive of sleep apnea declined pacemaker therapy and remained asymptomatic. From these results, we concluded that asymptomatic transient bradyarrhythmias may suggest a diagnosis of sleep apnea. The evaluation of a patient referred for pacemaker therapy with asymptomatic bradyarrhythmias should include questions related to sleep apnea symptoms. Establishing the diagnosis of sleep apnea may reduce the need for pacemaker therapy and permit appropriate treatment of the underlying cause of these bradyarrhythmias.
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PMID:Asymptomatic bradyarrhythmias as a marker for sleep apnea: appropriate recognition and treatment may reduce the need for pacemaker therapy. 877 19


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