Gender differences of cardiovascular diseases risk in the population with sleep disorders: WHO’s program MONICA-psychosocial

OBJECTIVE To determine the gender differences in the effect of sleep disorders (SD) on the risk of myocardial infarction (MI) and stroke in an open population, aged 25-64 years, of Russia/Siberia over 16 years of follow-up. MATERIAL AND METHODS Within the framework of the III screening of WHO's MONICA-psychosocial program, a random representative sample of the Novosibirsk population, which comprised both sexes (657 men, 689 women), aged 25-64 years, was examined in 1994. The screening included socio-demographic data, the assessment of SD according to the Jenkins scale. The analysis included people without MI, stroke. In 16 years, new-onset cases of MI and stroke were identified in women (15 and 35 cases, respectively) and in men (30 and 22 cases, respectively). RESULTS In the open population among the population of 25-64 years, 48.6% of men and 65.9% of women had SD (c2=24.427, df=1, p=0.0001). In people with SD, a single-factor Cox regression analysis revealed that the risk of stroke was higher in men than in women within a 16-year period. Multivariate Cox regression analysis revealed that in people with SD, the risk of stroke in men and women is approximately the same. Widowed men with SD had an increased risk of stroke. The risk of stroke was higher in men with incomplete secondary / primary education than in women. There was an increased risk of stroke in women with secondary education and those having sleep problems. Cox single-factor regression analysis showed an increased risk of MI (by 2.4 times) in men with SD for a 16-year period. SD did not influence the risk of MI in women. The risk of MI was 3 times higher in never-married men, 4.3 times higher in divorced men and 7.5 times higher in widowed men. CONCLUSION SD are a risk factor for stroke in men and women, and a risk factor of MI in men. A negative social gradient increases the risk of cardiovascular diseases in people with SD.