Biomedical subjects

J B Croft

Publications and source records attributed to J B Croft.

At least 19 recordsLinked to original sources

PubMed1999

Racial differences in the incidence of intracerebral hemorrhage: effects of blood pressure and education.

OBJECTIVE: To determine the relative risk (RR) of intracerebral hemorrhage (ICH) among African Americans compared with that among whites. METHODS: Data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study were used to determine the incidence of ICH (n = 78) in 10,851 whites and 1,802 African Americans during a 20-year follow-up period. Cox proportional hazards analyses were used to determine the RR of ICH among African Americans compared with that among whites. RESULTS: The estimated annual incidence of ICH was 50 per 100,000 among African Americans and 28 per 100,000 among whites. The age- and sex-adjusted RR for ICH among African Americans was 1.9 (95% confidence interval [CI], 1.1 to 3.2). With the addition of systolic blood pressure and educational attainment to the Cox proportional hazards model, the RR decreased to 1.6 (95% CI, 0.9 to 2.7). The adjustment for additional cerebrovascular disease risk factors did not change this risk estimate appreciably. CONCLUSIONS: Compared with whites, African Americans have a twofold increased risk for ICH. Most of this risk may be explained by differences in educational attainment and systolic blood pressure. Unless additional efforts are undertaken to reduce racial differences in the prevalence of stroke risk factors, mainly systolic blood pressure and socioeconomic status, the African American-white disparities in the risk for ICH will likely continue.

Adult↗

PubMed1999

Heart failure survival among older adults in the United States: a poor prognosis for an emerging epidemic in the Medicare population.

OBJECTIVE: To describe the 6-year probability of survival for older adults after their first hospitalization for heart failure. SETTING: National Medicare hospital claims records for 1984 through 1986 and Medicare enrollment records from 1986 through 1992. DESIGN: We identified a national cohort of 170 239 (9% black patients) Medicare patients, 67 years or older, with no evidence of heart failure in 1984 or 1985, who were hospitalized and discharged for the first time in 1986 with a principal diagnosis of heart failure. For groups defined by race, sex, age, Medicaid eligibility, and comorbid conditions, we compared the probability of survival with Cox proportional hazards regression. RESULTS: Only 19% of black men, 16% of white men, 25% of black women, and 23% of white women survived 6 years. One third died within the first year. Men had lower median survival and 38% greater risk of mortality than did women (P<.05). White men had 10% greater risk of mortality than did black men (P<.05). Medicaid eligibility (white adults only) and diabetes were associated with increased mortality (P<.05). CONCLUSIONS: The prognosis for older adults with heart failure underscores the importance of prevention strategies and early detection and treatment modalities that can prevent, improve, or reverse myocardial dysfunction, particularly for the growing number of adults who are at increased risk for developing heart failure because of hypertension, diabetes, or myocardial infarction.

Black or African American↗

PubMed1999

Hospitalization of patients with heart failure: National Hospital Discharge Survey, 1985 to 1995.

BACKGROUND: In the United States, heart failure has emerged as the leading first-listed diagnosis among hospitalized older adults. METHODS: The number and prevalence of hospitalizations, procedure use, and discharge outcomes for men and women aged >/=35 years hospitalized with heart failure were estimated from National Hospital Discharge Survey data for the years 1985 through 1995. RESULTS: In 10 years, the number of hospitalizations increased from 577,000 to 871,000 for a first-listed diagnosis and from 1.7 to 2.6 million for any diagnosis of heart failure. Almost 78% of men and 85% of women hospitalized with heart failure were aged >/=65 years. Among persons hospitalized with any diagnosis of heart failure, in-hospital mortality rate decreased from 1985 to 1995 whereas prevalence of discharge to long-term care increased. In 1995, 67% of male patients were discharged home, 12% were discharged to long-term care, and 8% died during hospitalization; the corresponding values for female patients were 58%, 21%, and 8%. Men had twice the prevalence of invasive cardiac procedures as did women during hospitalization. CONCLUSIONS: The growing burden of heart failure can be expected to increase during the next decade unless innovative interventions and primary and secondary prevention strategies are implemented.

Adult↗

PubMed1999

Vaginal estrogen creams: use patterns among a cohort of women.

OBJECTIVE: To assess the prevalence, amount, and duration of use of vaginal estrogen cream among several birth cohorts of women from 1983 through 1992. DESIGN: Analyses are based on automated membership, pharmacy, and hospital discharge databases from Group Health Cooperative (GHC) of Puget Sound, a large health maintenance organization in Seattle, Washington. PARTICIPANTS: A total of 33,822 women, aged 45 years and older as of December 31, 1983, who were enrolled in GHC from 1983 to 1992 or who were enrolled at baseline and died in the following decade. RESULTS: About 24% of the cohort had filled at least one prescription for vaginal estrogen cream during 1983 through 1992, and about 60% of the users had more than one prescription filled. The annual birth cohort-specific prevalence of having filled one or more prescriptions for vaginal estrogen creams ranged between 1.6 and 8.2% across birth cohorts, whereas the average annual prevalence for the cohort was between 5.3 and 6.8%. The total amount, duration of use, and proportion of total estrogen exposure from creams increased with age of the birth cohort. Among the 733 women with intact uteri who were long-term cream users, 60.4% had no progestin prescriptions while averaging 22.1 tubes of estrogen cream. CONCLUSION: The prescription-filling patterns for estrogen in this cohort show an increase in the amount, years of use, and proportion of estrogen exposure from creams with the age of the birth cohort and extensive unopposed cream use among a small proportion of women with intact uteri. The systemic effects of vaginal estrogen cream among older postmenopausal women with urogenital atrophy deserve closer scrutiny.

Administration, Oral↗

PubMed1999

Prevalence and correlates of the insulin resistance syndrome among Native Americans. The Inter-Tribal Heart Project.

OBJECTIVE: The clustering of factors characterizing the insulin resistance syndrome has not been assessed among Native Americans, a population at high risk for diabetes and cardiovascular disease. We examined the distribution and correlates of the insulin resistance syndrome among individuals in three Chippewa and Menominee communities in Wisconsin and Minnesota. RESEARCH DESIGN AND METHODS: Cross-sectional data from 488 men and 822 women ages > or = 25 years in the Inter-Tribal Heart Project (1992-1994) were included. The clustering of each individual trait (hypertension, diabetes, high triglycerides, and low HDL cholesterol) with the other traits and the association of the number of traits with measures of adiposity and insulin levels were examined. RESULTS: Among the men, 40.4, 32.6, 17.4, and 9.6% had none, one, two, or at least three of the four traits, respectively; among the women, the respective percentages were 53.2, 25.6, 15.3, and 6.0%. The percentage of individuals with each particular trait significantly increased (P < 0.01) among those with none, one, or at least two other syndrome traits. Having more syndrome traits was significantly related (P < 0.001) to higher BMI, conicity index, waist circumference, and waist-to-hip and waist-to-thigh ratios. Among individuals with normal glucose levels, having more syndrome traits was significantly related (P < or = 0.05) to higher fasting insulin levels after adjusting for age and measures of adiposity, although associations were attenuated with adjustment for either BMI or waist circumference. CONCLUSIONS: Traits characterizing the insulin resistance syndrome were found to be clustered to a significant degree among Native Americans in this study. Comprehensive public health efforts are needed to reduce adverse levels of these risk factors in this high-risk population.

Adipose Tissue↗

PubMed1998

Serum folate and risk for coronary heart disease: results from a cohort of US adults.

PURPOSE: To assess the role of serum folate in the risk for coronary heart disease in a national cohort of US adults. METHODS: Data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study (N = 1921) were used to determine whether a low serum folate concentration was associated with an increased risk for incident coronary heart disease (N = 284). The Cox proportional hazards model adjusted for age, sex, race, education, serum cholesterol, systolic blood pressure, body mass index, cigarette smoking, and alcohol consumption. RESULTS: The association between folate and risk for coronary heart disease differed by age group (p = 0.03). Among persons aged 35-55 years, the relative risk for heart disease was 2.4 (95% confidence interval (CI), 1.1-5.2) for persons in the lowest quartile (< or = 9.9 nmol/L) when compared with those in the highest quartile (> or = 21.8 nmol/L). However, among persons > or = 55 years the relative risk was 0.5 (95% CI, 0.3-0.8) for comparisons of the lowest versus highest quartiles. CONCLUSIONS: If the age differences in the risk for heart disease are confirmed, randomized clinical trials assessing the role of folic acid for the prevention of heart disease may need to include young adults in order to demonstrate benefits related to folate supplementation.

Adult↗

PubMed1998

American Indian heritage and risk factors for renal injury.

BACKGROUND: Little is known about the causes and consequences of renal disease among American Indians in the Great Lakes region of the United States. METHODS: We examined clinical correlates of albumin/creatinine ratios among 1368 participants in the three tribal communities of the Inter-Tribal Heart Project using univariate and multivariate analysis. RESULTS: Compared to 1086 participants without albuminuria, the 240 with microalbuminuria (30 to 299 mg/g) and the 42 with macroalbuminuria (>300 mg/g) were more likely to report a history of a myocardial infarction (6.4%, 16.0%, and 23.8%, respectively, P < 0.001). Similarly, compared to patients without albuminuria, those with microalbuminuria and macroalbuminuria were more likely to report a history of stroke (2.3%, 8.4% and 26.2%, respectively, P < 0.001). In a multiple linear regression model, independent correlates of albumin excretion (P < 0.05) included: fasting blood sugar, treated diabetes, treated hypertension, higher systolic blood pressure, lower diastolic blood pressure, abnormal electrocardiogram, a history of stroke, the degree of American Indian heritage, and lower household income. CONCLUSIONS: Urinary albumin excretion is associated with cardiovascular disease outcomes and risk factors among American Indians of the Great Lakes region. Both heredity and socioeconomic status appear to play a role in the pathogenesis of renal injury in this population.

Adult↗

PubMed1998

Prevalence of multiple cardiovascular disease risk factors among women in the United States, 1992 and 1995: the Behavioral Risk Factor Surveillance System.

We sought to examine the prevalence of self-reported multiple cardiovascular disease (CVD) risk factors (hypertension, high blood cholesterol, diabetes, overweight, and current smoking) among women in 1992 and 1995 in the United States using data from the Behavioral Risk Factor Surveillance System. In 1992, 37.5%, 34.4%, and 28.1% of women had zero, one, and two or more of the five risk factors, respectively. In 1995, the respective estimates were 35.5%, 34.3%, and 30%. In both years, the prevalence of two or more risk factors increased with age, decreased with educational level, was higher among black women (lowest among Hispanic women and women of other ethnic groups), and higher among women reporting cost as a barrier to healthcare. The percentage of women with two or more risk factors was higher in 1995 than in 1992 for 35 of 48 states, being statistically significant for 7 states. The percentage of women with at least two risk factors was not significantly lower in 1995 than in 1992 for any state. A higher percentage of women reported having multiple CVD risk factors in 1995 compared with 1992. A multifactorial approach to primary prevention and risk factor reduction should be encouraged to help reduce the prevalence and burden of CVD among women.

Adolescent↗

PubMed1998

Total homocyst(e)ine concentration and the likelihood of nonfatal stroke: results from the Third National Health and Nutrition Examination Survey, 1988-1994.

BACKGROUND AND PURPOSE: Elevated serum total homocyst(e)ine [H(e)] is an independent risk factor for stroke. Few studies, however, have examined this association in blacks. METHODS: Data from the Third National Health and Nutrition Examination Survey (n=4534), a nationally representative sample of US adults, were used to examine the relationship between H(e) and a physician diagnosis of stroke (n=185) in both black and white adults. Multivariate-adjusted logistic regression analyses were used to examine this relationship. RESULTS: Serum vitamin B12 and folate concentrations were significantly lower among participants in the highest H(e) quartile (>/=12.1 micromol/L) than among participants in the lowest quartile (</=7.4 micromol/L). Those in the highest quartile were older, had higher mean cholesterol and blood pressure levels, and were more likely to smoke and to have completed <12 years of education. After adjustment for age, the odds ratio (OR) for stroke was 2.9 (95% confidence interval [CI], 1.4 to 5.7; highest versus lowest quartile). Adjustment for gender, race/ethnicity, education, systolic blood pressure, cholesterol, diabetes mellitus, and smoking reduced the magnitude of the association (OR, 2.3; 95% CI, 1.2 to 4. 6). The association between H(e) and stroke did not differ by race [P=0.265 for race-H(e) interaction term]. The multivariate adjusted OR for the highest quartile versus the lowest was 2.5 (1.1 to 5.5) among whites and 1.4 (0.4 to 4.7) among blacks. CONCLUSIONS: In this nationally representative sample of US adults, H(e) concentration was independently associated with an increased likelihood of nonfatal stroke. This association was present in both black and white adults.

Aged↗

PubMed1998

Platelet glycoprotein receptor IIIa polymorphism P1A2 and ischemic stroke risk: the Stroke Prevention in Young Women Study.

BACKGROUND AND PURPOSE: Platelet glycoprotein IIb/IIa (GpIIb-IIIa), a membrane receptor for fibrinogen and von Willebrand factor, has been implicated in the pathogenesis of acute coronary syndromes but has not been previously investigated in relation to stroke in young adults. METHODS: We used a population-based case-control design to examine the association of the GpIIIa polymorphism P1A2 with stroke in young women. Subjects were 65 cerebral infarction cases (18 patients with and 47 without an identified probable etiology) 15 to 44 years of age from the Baltimore-Washington region and 122 controls frequency matched by age from the same geographic area. A face-to-face interview for vascular disease risk factors and a blood sample for the P1A2 allele and serum cholesterol were obtained from each participant. Logistic regression was used to estimate the odds ratio for one or more P1A2 alleles after adjustment for other risk factors. RESULTS: Among cases and controls, the prevalence rates of one or more P1A2 alleles were 21% and 22% among blacks and 36% and 28% among whites, respectively. This genotype was significantly associated with hypertension only in black control subjects but otherwise not with any of the established vascular risk factors. The adjusted odds ratio for cerebral infarction of one or more P1A2 alleles was 1.1 (confidence interval [CI], 0.6 to 2.3) overall, 0.5 (CI, 0.1 to 7.1) among blacks, and 1.4 (CI, 0.5 to 3.7) among whites. For the cases with an identified probable etiology, the corresponding odds ratios were 3.0 (CI, 0.9 to 10.4) overall, 0.7 (CI, 0.1 to 7.1) among blacks, and 12.8 (CI, 1.2 to 135.0) among whites. CONCLUSIONS: No association was found between the P1A2 polymorphism of GpIIIa and young women with stroke. However, subgroup analyses showed that the P1A2 polymorphism of GpIIIa appeared to be associated with stroke risk among white women, particularly those with a clinically identified probable etiology for their stroke. Further work with an emphasis on stroke subtypes and with multiracial populations is warranted.

Adolescent↗

PubMed1998

Impaired glucose tolerance and the likelihood of nonfatal stroke and myocardial infarction: the Third National Health and Nutrition Examination Survey.

BACKGROUND AND PURPOSE: Although diabetes mellitus (DM) is known to increase the risk of cardiovascular disease (CVD), the effect of impaired glucose tolerance (IGT) on the risk remains unclear. We determined whether IGT was associated with an increased likelihood for stroke and myocardial infarction in a nationally representative sample of US adults. METHODS: We evaluated the association between IGT (defined as a fasting glucose level of < 140 mg/dL and a plasma glucose level of between 140 and 200 mg/dL 2 hours after administration of 75 grams of an oral glucose load) and DM (defined as the current use of insulin or an oral hypoglycemic medication, a fasting plasma glucose level of > 140 mg/dL, or a plasma glucose level of > 200 mg/dL 2 hours after administration of an oral glucose load) with a self-reported physician diagnosis of stroke and myocardial infarction in 6547 adults aged 40 to 74 years participating in the Third National Health and Nutrition Examination Survey. Multivariate logistic regression analyses were used to investigate these relationships. RESULTS: IGT and DM were observed in 1494 and 1532 adults, respectively. After adjustment for differences in age, gender, race/ethnicity, education, hypertension, cholesterol, body mass index, and cigarette smoking, IGT was not associated with stroke (odds ratio [OR], 0.9; 95% confidence interval [CI], 0.5 to 1.6) or myocardial infarction (OR, 1.1; 95% CI, 0.7 to 1.6). DM was associated with both stroke (OR, 1.6; 95% CI, 1.0 to 2.6) and myocardial infarction (OR, 1.9; 95% CI, 1.3 to 2.8). CONCLUSIONS: In contrast to DM, IGT was not associated with an increased likelihood of prevalent nonfatal stroke or myocardial infarction.

Adult↗

PubMed1998

Thermolabile methylenetetrahydrofolate reductase polymorphism (C677T) and total homocysteine concentration among African-American and white women.

A polymorphism associated with a thermolabile variant (C677T) of the enzyme methylenetetrahydrofolate reductase has been associated with both elevated total homocysteine (tHcy) levels and risk for cardiovascular disease. Data from the Stroke Prevention in Young Women Study were used to determine the prevalence of the C677T genotype and to assess whether environmental factors modified the association between genotype and tHcy concentration. The C677T genotype prevalence was 80% -/-, 20% +/-, and 0% +/+ among 46 African-American women; and 39% -/-, 53% +/-, and 8% +/+ among 77 white women (P < 0.01). There was a trend toward higher tHcy levels in African-American women with the +/- genotype when compared with the -/- genotype (6.9 mumol/L vs 5.3 mumol/L respectively, p = 0.10); no association was found among the white women (6.0 mumol/L, -/-; 4.5 mumol/L, +/-; and 6.2 mumol/L, +/+; p = 0.67). Among African American women, those who smoked and were +/- genotype had the highest tHcy levels (8.0 mumol/L); while among white women, those who smoked and were -/- had the highest tHcy levels (8.1 mumol/L). Despite being hampered by a limited sample size, the thermolabile allele is significantly less common among African-American than white women. The association between genotype and tHcy concentration is influenced by smoking and multivitamin use.

Adolescent↗

PubMed1997

Number of pregnancies and risk for stroke and stroke subtypes.

OBJECTIVE: To examine the effect of the number of pregnancies on the subsequent risk for stroke and stroke subtypes. DESIGN: Prospective cohort study. PARTICIPANTS: National cohort of 3852 women aged 45 to 74 years who participated in the first National Health and Nutrition Examination Survey Epidemiology Follow-up Study. MAIN OUTCOME MEASURES: Stroke, cerebral infarction, and intracerebral hemorrhage during a 20-year follow-up period. RESULTS: After adjusting for differences in age, women with 6 or more pregnancies were at an increased risk for any type of stroke (relative risk [RR] = 1.7; 95% confidence interval [CI], 1.2-2.3) and cerebral infarction (RR = 1.6; 95% CI, 1.2-2.3). Adjustment for stroke risk factors explained some but not all of the risk associated with pregnancy (RR = 1.3; 95% CI, 0.9-1.9 for all stroke, and RR = 1.3; 95% CI, 0.9-1.9 for cerebral infarction). The rate of intracerebral hemorrhage was 3-fold higher among women who had been pregnant when compared with nulligravida women; however, this finding did not reach statistical significance possibly because of the small number of intracerebral hemorrhages (n = 33). CONCLUSION: The number of pregnancies may influence the risk for stroke, particularly cerebral infarction, in women.

Aged↗

PubMed1997

Major depression and all-cause mortality among white adults in the United States.

PURPOSE: Depression is the most common psychiatric illness affecting adults. Despite the importance of a potential link between major depression and mortality, research has been surprisingly sparse. METHODS: Information on 57,897 white adults aged 25 years and older who were included in the mental health supplement of the 1989 National Health Interview Survey was linked with the National Death Index to examine the relationship of major depression to mortality. Death status was obtained through December 1991. Sex-specific hazard rate ratios for mortality were calculated by Cox proportional hazards regression and Poisson regression to adjust for potential confounders (age, education, marital status, body mass index, and whether the target subject or a family member completed the survey about the subject). RESULTS: Major depression was reported for 223 (0.8%) of 27,345 men and 392 (1.3%) of 30,552 women. During the 2.5-year follow-up, death certificate data were obtained for 848 (3.1%) men and 651 (2.1%) women. The adjusted hazard rate ratios for all-cause mortality associated with major depression were 3.1 (95% confidence interval; 2.0-4.9) for men and 1.7 (95% confidence interval; 0.9-3.1) for women. CONCLUSIONS: These results suggest that major depression increases risk of all-cause mortality, particularly among men. Further research is needed to explain the mechanism.

Adult↗

PubMed1997

Effect of body mass index on activity limitation and mortality among older women: the National Health Interview Survey, 1986-1990.

We assessed the impact of body mass on the association between activity limitations due to chronic conditions and mortality among 24,612 noninstitutionalized white or African American women aged > or = 65 years who participated in a National Health Interview Survey between 1986 and 1990. We found that more African American women had activity limitations than white women (59% vs 46%, respectively). The difference by race was greatest (19% vs 10%) for the most severe limitation (unable to perform the major activity). For women aged 65-69, the major activity was working or keeping house; for those aged > or = 70, it was the ability to live independently. For white women in all three categories of body mass index (BMI) and for African American women with BMI 15%-85%, the risk of dying was significantly higher for those unable to perform the major activity than for those with no limitations, controlling for the effects of education, marital status, and perceived health. The findings confirm the established link between low BMI and mortality and between activity limitations and mortality. Additionally, the findings further suggest that activity limitations linked to chronic conditions increase the risk of death within each stratum of BMI after adjusting for potential confounders.

Activities of Daily Living↗

PubMed1997

Social support, stress, and blood pressure in black adults.

Psychosocial factors arising from socioeconomic disadvantage and discrimination may contribute to the excess risk of elevated blood pressure in African-Americans. The purpose of this study was to assess the association of social support and stress with blood pressure in a community-based sample of 25-to 50-year-old black adults in Pitt County, NC. A stratified random sample of dwellings was selected in 1988, and 1,784 black adults (80% of those eligible) were interviewed. Analyses were sex specific and adjusted for age, obesity, and waist/hip ratio. In separate analyses of emotional support, instrumental support, and stress with blood pressure, all associations were in the predicted direction (inverse for support, direct for stress) but were stronger for systolic than for diastolic blood pressure. Differences in systolic blood pressure associated with low support or high stress ranged from 5.2 to 3.6 mmHg in women and 3.5 to 2.5 mmHg in men. In simultaneous regression analyses of support and stress, each of the separate effects was reduced for women, but a sizable aggregate effect of low support and high stress remained [+7.2 mmHg (95% confidence limits = +1.3, +13.1) for systolic blood pressure and +4.0 mmHg (95% confidence limits = +0.1, +7.9) for diastolic blood pressure.

Adult↗

PubMed1997

National trends in the initial hospitalization for heart failure.

OBJECTIVES: Heart failure is a major health care burden among older adults, but information on recent trends has not been available. We compare rates, sociodemographic characteristics, and discharge outcomes of the initial hospitalization for heart failure in the Medicare populations of 1986 and 1993. DESIGN: Information reported on the Medicare hospital claims record during initial hospitalization for heart failure was compared for patients aged 65 and older hospitalized in 1986 (N = 631,306) and those aged 65 and older hospitalized in 1993 (N = 803,506). RESULTS: Age-standardized hospitalization rates (per 1000 person-years) for any diagnosis of heart failure were higher in 1993 than in 1986 (white: 24.6 vs 22.4, black: 26.1 vs 22.4, respectively). Age-specific results suggested an earlier onset of heart failure in black adults. In 1993, compared with 1986, higher proportions of heart failure patients were discharged to another care facility (white: 23.9% vs 16.8%, black: 17.6% vs 10.5%, respectively) or to health service care at home (white: 11.3% vs 6.0%, black: 12.4% vs 6.5%, respectively). In contrast, in-hospital mortality was lower in 1993 than in 1986 (white: 10.4% vs 13.3%, black: 8.9% vs 11.1%, respectively). CONCLUSION: The increased numbers of hospitalizations for heart failure and the likelihood that these patients will require advanced nursing care after discharge have important implications for future national health care expenditures and resources.

Age Distribution↗

PubMed1997

Habitual sleep patterns and risk for stroke and coronary heart disease: a 10-year follow-up from NHANES I.

BACKGROUND: Habitual sleep patterns may independently affect morbidity and mortality. However, the effect of habitual sleep patterns on the risk for stroke and coronary heart disease is unclear. METHODS: We evaluated the association between sleep duration and daytime somnolence (often or almost always taking daytime naps) with the incidence of stroke and coronary heart disease in a national cohort of 7,844 adults who participated in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Cox proportional hazards analyses were used to examine these relationships during the 10-year follow-up. RESULTS: After adjusting for differences in age, race, gender, education, cigarette smoking, body mass index, serum cholesterol, systolic blood pressure, and diabetes mellitus, the risk for stroke was increased in persons who reported sleeping greater than 8 hours at night compared with persons who slept between 6 and 8 hours (relative risk [RR] = 1.5, 95% confidence interval [CI] = 1.1 to 2.0). Daytime somnolence was also associated with stroke incidence (RR = 1.4, 95% CI = 1.1 to 1.8). Persons who reported both greater than 8 hours of sleep and daytime somnolence were at the greatest risk for stroke (RR = 1.9, 95% CI = 1.2 to 3.1). Similar results were also found for coronary heart disease, although the results did not reach statistical significance in the multivariate adjusted model. CONCLUSIONS: Habitual sleep patterns have significant effects on the risk for stroke.

Adult↗