Susanna C. Larsson
Genetic liability for insomnia was associated with a modest but increased risk for CAD, HF and ischemic stroke, in addition to BMI, waist-to-hip ratio and type 2 diabetes, according to a new study published in Circulation.
Adults with genetic liability to insomnia had greater risk for ischemic stroke (OR = 1.07; 95% CI, 1.04-1.11), as well as several ischemic stroke subtypes including large-artery stroke (OR = 1.13; 95% CI, 1.03-1.24), small vessel stroke (OR = 1.08; 95% CI, 0.99-1.17) and cardiometabolic stroke (OR = 1.06; 95% CI, 0.99-1.14); CAD (OR = 1.12; 95% CI, 1.08-1.17); and HF (OR = 1.16; 95% CI, 1.09-1.24), even after adjustment for genetically correlated factors including smoking, depression and education. However, genetic liability insomnia was not associated with AF.
“These findings emphasize the need to treat insomnia — for example through changes in behaviors, lifestyle and stress management, as a part of treatment of other traditional risk factors for CVD,” Susanna C. Larsson, PhD, of the unit of cardiovascular and nutritional epidemiology at Karolinska Institutet, told Cardiology Today. “Possible mechanisms whereby insomnia increases CVD risk is by increasing the risk of the metabolic syndrome, including body weight, BP and type 2 diabetes.”
The study used Mendelian randomization to exploit genetic variants associated with risk factors to determine whether risk factors are the cause of a disease, according to the researchers. Meta-analysis of genome-wide association studies was performed in a cohort of 1,331,010 adults with insomnia complaints. The researchers then selected single-nucleotide polymorphisms, or SNPs, known to be associated with insomnia complaints. In total, the analysis included 243 SNPs for CAD, 246 SNPs for HF and atrial fibrillation and 244 for ischemic stroke.
“Although we used genetic variants as proxy indicators to measure insomnia, the patient should be aware of that insomnia is mainly determined by environmental factors, such as behavior, lifestyle and stress, and not so much by our genes,” Larsson said. “There is a need for further research on the mechanisms whereby insomnia increases CVD risk and whether changes in behaviors, lifestyle and stress management could reduce those intermediate risk factors.” – by Scott Buzby
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Susanna C. Larsson, PhD , can be reached at email@example.com
Disclosures: Larsson reports no relevant financial disclosures. The other authors report no relevant financial disclosures.