1. Conflict of interest: None declared.
The contribution of short sleep duration to ethnic differences in cardiovascular disease in the Netherlands – the HELIUS study
Kenneth Anujuo, Charles Agyemang, Marieke Snijder, Girardin Jean-Louis, Bert-Jan van den Born, Ron Peters, Karien Stronks.
Department of Public Health, Academic Medical Center, University of Amsterdam
Conflict of interest: None declared.

2. Background CVD is the leading cause of death.
Studies indicate association between sleep duration and CVD and risk factors
Little focus on ethnic minority groups.
Lack of data on contribution of short sleep to CVD.

3. Objectives
Investigate the association between short sleep and CVD among ethnic groups in Amsterdam.
Assess the contribution of short sleep to the observed ethnic differences in CVD.

4. Methods HELIUS STUDY (Healthy life in an urban setting)
Comparisons among the groups were made using proportions and adjusted prevalence ratio(s) (PR).
HELIUS STUDY (Healthy life in an urban setting)
20730 Participants
Aged 18-71
Sleep duration
short (<7 hours/night)
Healthy(7-9 hours/night)
Prevalent CVD (questionnaire myocardial infarction, angina pectoris, and intermittent claudication)

5. Fig. 1: Conceptual model

6. RESULTS

7. PR = prevalence ratio; short sleep was referenced to healthy sleep.
Relationship between short sleep and CVD by ethnicity
Dutch
n = 4495
South-Asian Surinamese
n = 2933
African Surinamese
n = 4039
Ghanaians
n = 2181
Turkish
n = 3395
Moroccans
n = 3687
PR (95%CI)
Crude
2.05 ( )*
1.67 ( )*
1.52 ( )*
1.46 ( )**
1.56 ( )*
1.44 ( )*
Model 1
1.84 ( )*
1.59 ( )*
1.56 ( )*
1.54 ( )*
1.51 ( )*
1.39 ( )*
Model 2
1.62 ( )**
1.53 ( )*
1.51 ( )*
1.55 ( )*
1.46 ( )*
1.41 ( )*
PR = prevalence ratio; short sleep was referenced to healthy sleep.
Model 1: adjusted for age and sex, Model 2: adjusted for model 1 plus BMI, WHR, hypertension, diabetes, dyslipidaemia, smoking, alcohol consumption, and physical activity. (*: p<0.001; **: p<0.005)

9. Discussion/conclusion
CVD higher in short sleepers in all ethnic groups.
Sleep contributes 5-15% to ethnic differences in CVD
Reducing sleep deprivation may be of help to reducing ethnic inequalities in CVD

10. Thank you/Questions.

11. References
Mensa GA, Mogdad AH, Ford ES, et al. State of disparities in cardiovascular health in the United States. Circulation. 2005;111:
Agyemang C, van Oeffelen AA, Norredam M, et al. Ethnic disparities in ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage incidence in the Netherlands. Stroke. 2014;45:
Wolk R, Gami AS, Garcia-Touchard A, et al. Sleep and cardiovascular disease. Curr Probl Cardiol. 2005;30:
Anujuo K, Stronks K, Snijder MB, et al. Relationship between short sleep duration and cardiovascular risk factors in a multi-ethnic cohort – the HELIUS study. Sleep Med. 2105;12: