Contribution of short sleep duration to ethnic differences in cardiovascular disease: results from a cohort study in the Netherlands

BMJ Open. 2017 Nov 17;7(11):e017645. doi: 10.1136/bmjopen-2017-017645.


Objectives: We analysed association between short sleep duration and prevalence of cardiovascular disease (CVD) in a multiethnic population living in the Netherlands, and the contribution of short sleep to the observed ethnic differences in the prevalence of CVD, independent of CVD risk factors.

Methods: 20 730 participants (aged 18-71 years) of the HELIUS (Healthy Life in an Urban Setting) Study were investigated. Self-reported sleep duration was classified as: short (<7 hours/night) and healthy (7-9 hours/night). Prevalence of CVD was assessed using the Rose Questionnaire on angina pectoris, intermittent claudication and possible myocardial infarction. Association of short sleep duration with prevalent CVD and the contribution of short sleep to the observed ethnic differences in the prevalence of CVD were analysed using adjusted prevalence ratio(s) (PRs) with 95% CI.

Results: Results indicate that short sleep was associated with CVD among all ethnic groups with PRs ranging from 1.44 (95% CI 1.20 to 1.71) in Moroccans to 1.74 (95% CI 1.28 to 2.36) in Dutch after adjustment for age, sex and conventional CVD risk factors. The independent contributions of short sleep (in percentage) to ethnic differences in CVD compared with Dutch were 12%, 16%, 6%, 19% and 6% in South-Asian Surinamese, African-Surinamese, Ghanaian, Turkish and Moroccan, respectively.

Conclusion: Short sleep contributed to ethnic differences in CVD independent of well-known CVD risk factors particularly in Surinamese and Ghanaian groups. Reducing sleep deprivation may be a relevant entry point for reducing increased CVD risks among the various ethnic minority groups.

Keywords: cardiovascuiar disease; ethnicity; helius study; minority groups; sleep duration.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiovascular Diseases / epidemiology*
  • Cohort Studies
  • Ethnicity / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Prevalence
  • Risk Factors
  • Sleep / physiology*
  • Young Adult