Good Sleep Patterns Reduce Heart Disease Risk Despite Genetic Influences

Highlights:

Healthy sleep patterns can reduce the risk of cardiovascular diseases (CVD)
These sleep patterns nullify genetic susceptibility to heart disease and stroke
This could lead to elucidation of the underlying mechanism involved in the role of sleep in reducing CVD risk

Sleep plays a key role in maintaining physical health. Unhealthy sleep habits may up the risk of cardiovascular diseases (CVD). Therefore, sleep is important to keep the heart healthy. Getting a good night's sleep can reduce the risk of developing heart disease and stroke despite genetic influences, reveals a new study from Tulane University, USA.

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Sleeping too Much or too Little Increases Risk of Heart Attack
People at high genetic risk for heart attack, sleeping between 6 and 9 hours nightly can offset that risk, revealed new study.

‘Healthy sleep patterns can reduce the risk of cardiovascular diseases (CVD) and stroke, despite genetic susceptibility.’
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The study, published in the European Heart Journal, was led by Professor Lu Qi, MD, PhD, who is the HCA Regents Distinguished Chair and Director, Tulane University Obesity Research Center, New Orleans, LA, USA. He is also an Adjunct Professor of Nutrition at the Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Research Objectives

The major objectives of the research are highlighted below:

Establishment of whether the relation between sleep scores and cardiovascular events was influenced by genetic risk
Estimation of the proportion of cardiovascular events that could have been averted if all the participants had healthy sleep patterns

Key Features of the Study

385,292 healthy participants from the UK Biobank Project were included in the prospective study
All patients suffering from CVD were excluded from the study
The following factors that could influence the results were taken into account while designing the study:

Age
Sex
Ethnicity
Physical activity
Body mass index (BMI)
Smoking
Alcohol consumption
Sleep deprivation
Family history of heart disease and stroke
Other health problems

Genetic variations called SNPs (single nucleotide polymorphisms) linked to the development of CVD were studied
SNPs from blood samples of the participants were analyzed
Genetic Risk Score was developed based on the SNP analysis, which categorized participants into the following:

High risk of developing CVD
Intermediate risk of developing CVD
Low risk of developing CVD

Healthy Sleep Score (HSS) was developed based on the following parameters of the participants:

Morning or evening person
Duration of sleep
Presence of insomnia
Presence of snoring
Excessive daytime sleepiness

HSS ranged from 0 to 5, which exhibited the following features:

HSS 5: Healthiest sleep pattern - Persons had 7-8 hours sound sleep at night, without snoring, insomnia or daytime sleepiness
HSS 0: Least healthiest sleep pattern - Persons experienced disturbed sleep

Average follow-up period was 8.5 years

Key Findings of the Study

7,280 cases of heart disease and stroke occurred during the follow-up period

Participants with HSS 5 compared to HSS 0-1 exhibited the following:

35 percent reduced risk of CVD
34 percent reduced risk of both heart disease and stroke
7 fewer cases of CVD per 1000 people annually

Effects of the following parameters on CVD were studied:

Group 1: High Genetic Risk + Unhealthy Sleep Pattern
Group 2: Low Genetic Risk + Healthy Sleep Pattern
Group 3: High Genetic Risk + Healthy Sleep Pattern
Group 4: Low Genetic Risk + Unhealthy Sleep Pattern

Results are indicated below:

Group 1 exhibited 2.5 fold higher risk of heart disease than Group 2
Group 1 exhibited 1.5 fold higher risk of stroke than Group 2
Group 3 exhibited 2.1 fold higher risk of heart disease than Group 2
Group 3 exhibited 1.3 fold higher risk of stroke than Group 2
Group 4 exhibited 1.7 fold higher risk of heart disease than Group 2
Group 4 exhibited 1.6 fold higher risk of stroke than Group 2

Interpretation of the Results

The findings indicate the following:

Among high genetic risk + unhealthy sleep pattern groups, there were 11 more cases of heart disease and 5 more cases of stroke per 1000 people annually, compared to low genetic risk + healthy sleep pattern groups
Healthy sleep pattern slightly compensated for high genetic risk, with just over 2 fold higher risk of CVD in this group of participants

"We found that a high genetic risk could be partly offset by a healthy sleep pattern," said Qi. "In addition, we found that people with low genetic risk could lose this inherent protection if they had a poor sleep pattern."

Limitations of the Study

Some of the major limitations of the study included the following:

Unhealthy sleep pattern could be indicative of an underlying or undetected health condition that increased the risk of CVD
Sleep patterns were assessed based on self-reporting by the participants only once at the start of the study
HSS did not include all sleep-related problems, including restless leg syndrome
Majority of the participants were of European origin, making it difficult to generalize the findings to other populations

Concluding Remarks

The research team couldn't find the exact mechanism that could explain the link between sleep patterns and CVD risk. They opined that altered sleep patterns could disrupt the body's hormonal or metabolic pathways and circadian rhythm, as well as increase inflammatory and 'fight or flight' responses, which could influence CVD risk.

Poor Sleep May Up Heart Disease Risk
Chronic sleep deprivation can increase the rate of biological aging and also increases up the risk of developing cardiovascular disease. Therefore, sleeping for more than seven hours can reduce the risk of heart disease.

Qi concluded: "As with other findings from observational studies, our results indicate an association, not a causal relation. However, these findings may motivate other investigations and at least suggest that it is essential to consider overall sleep behaviors when considering a person's risk of heart disease or stroke."

Funding Source

The study was funded by the NIH/National Heart, Lung, and Blood Institute and the NIH/National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA.

References :

Sleep Patterns, Genetic Susceptibility, and Incident Cardiovascular Disease: A Prospective Study of 385,292 UK Biobank Participants - (https://doi.org/10.1093/eurheartj/ehz849)
Can Good Sleep Patterns Offset Genetic Susceptibility to Heart Disease and Stroke? - (https://www.escardio.org/The-ESC/Press-Office/Press-releases/Can-good-sleep-patterns-offset-genetic-susceptibility-to-heart-disease-and-stroke)

Source: Medindia

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