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

Neomi Shah*, Matthew Allison, Yanping Teng, Sylvia Wassertheil-Smoller, Daniela Sotres-Alvarez, Alberto R. Ramos, Phyllis C. Zee, Michael H. Criqui, Henry K. Yaggi, Linda C. Gallo, Susan Redline, Robert C. Kaplan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective-Sleep apnea (SA) has been linked with various forms of cardiovascular disease, but little is known about its association with peripheral artery disease (PAD) measured using the ankle-brachial index. This relationship was evaluated in the Hispanic Community Health Study/Study of Latinos. Approach and Results-We studied 8367 Hispanic Community Health Study/Study of Latinos participants who were 45 to 74 years of age. Sleep symptoms were examined with the self-reported Sleep Health Questionnaire. SA was assessed using an in-home sleep study. Systolic blood pressure was measured in all extremities to compute the ankle-brachial index. PAD was defined as ankle-brachial index <0.90 in either leg. Multivariable logistic regression was used to investigate the association between moderate-to-severe SA, defined as apnea-hypopnea index ≥15, and the presence of PAD. Analyses were adjusted for covariates. The prevalence of PAD was 4.7% (n=390). The mean apnea-hypopnea index was significantly higher among adults with PAD compared with those without (11.1 versus 8.6 events/h; P=0.046). After adjusting for covariates, moderate-to-severe SA was associated with a 70% increase in the odds of PAD (odds ratio, 1.7; 95% confidence interval, 1.1-2.5; P=0.0152). This association was not modified by sex (P=0.8739). However, there was evidence that the association between moderate-to-severe SA and PAD varied by Hispanic/Latino background (P<0.01). Specifically, the odds were stronger in Mexican (adjusted odds ratio, 2.9; 95% confidence interval, 1.3-6.2) and in Puerto Rican Americans (adjusted odds ratio, 2.0; 95% confidence interval, 0.97-4.2) than in other backgrounds. Conclusions-Moderate-to-severe SA is associated with higher odds of PAD in Hispanic/Latino adults.

Original languageEnglish (US)
Pages (from-to)710-715
Number of pages6
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number3
StatePublished - Mar 1 2015


  • Hispanic Americans
  • ankle-brachial index
  • atherosclerosis
  • peripheral arterial disease
  • sleep apnea syndromes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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