Sex differences in the association between circadian rest-activity rhythms and cardiovascular disease among...

Area of Science:

• Chronobiology
• Cardiovascular Epidemiology
• Gerontology

Background:

• Aberrant circadian rest-activity rhythm (CRAR) is linked to cardiovascular disease (CVD) risk.
• Sex differences in CRAR's association with CVD and mortality are not well understood in middle-aged and older adults.

Purpose of the Study:

• To investigate sex-specific associations between CRAR and prevalent CVD, all-cause mortality, and cardiovascular mortality.
• To analyze data from a large, diverse U.S. population using accelerometry and health records.

Main Methods:

• Utilized data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 for participants aged ≥45 years.
• Derived parametric CRAR measures (amplitude, mesor, pseudo-F, acrophase) using an extended cosinor model from 7-day wrist actigraphy.
• Employed weighted multivariable logistic and Cox regression models to assess associations between CRAR measures and CVD/mortality outcomes.

Main Results:

• Participants in the lowest quintile of CRAR amplitude had 64% higher odds of prevalent CVD.
• Low CRAR amplitude and mesor were significantly associated with increased risks of all-cause and cardiovascular mortality.
• Associations between CRAR disruption and adverse outcomes were stronger in women, with significant interactions noted.

Conclusions:

• Disruption of the circadian rest-activity rhythm is a significant risk factor for cardiovascular disease and mortality.
• Sex-specific differences exist, with women experiencing stronger associations between CRAR disruption and adverse cardiovascular outcomes.
• Promoting robust circadian rhythms may be crucial for cardiovascular health and longevity, particularly in women.