Context Epidemiological studies have identified snoring as a risk factor for atherosclerotic cardiovascular diseases. However, there is little evidence on snoring and subclinical atherosclerosis.

Objective To evaluate whether and to what extent snoring is associated with carotid atherosclerosis.

Methods Population-based study was conducted at a community in Beijing on 1050 subjects aged 50–79 years who had an ultrasound examination of the carotid artery at age ranging from 45 to 74 years in 2002 and a carotid ultrasonic reexamination in 2007, as well as a cross-sectional survey including snoring information and cardiovascular risk factors from September to November 2007.

Main Outcome Measures Carotid intima-media thickness (IMT) and plaque as two indexes of carotid atherosclerosis were diagnosed by B-mode ultrasonography. Association of snoring with increased IMT and plaque were analysed by multivariable logistic regression models adjusted for cardiovascular risk factors.

Results The prevalence of snoring was 64.3% in this population (71.4% in males and 58.4% in females). In multivariable models adjusted for traditional risk factors, snoring was significantly associated with increased IMT of common carotid artery (CCA) (OR, 1.38; 95% CI 1.04 to 1.82) and bifurcated carotid artery (BCA) (OR, 1.65; 95% CI 1.24 to 2.19), with having plaque of CCA (OR, 1.62; 95% CI 1.01 to 2.58) and BCA (OR, 2.39; 95% CI 1.79 to 3.18), with newly detected increased IMT of BCA (OR, 1.60; 95% CI 1.11 to 2.30), and with newly detected plaque of BCA (OR, 2.14; 95% CI 1.57 to 2.93).

Conclusions There were distinct associations between snoring and carotid atherosclerosis, which provides evidence for a relation between snoring and subclinical atherosclerosis.