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. 2011 Apr;124(4):334-41.
doi: 10.1016/j.amjmed.2010.12.006.

Lung function and risk for heart failure among older adults: the Health ABC Study

Vasiliki V Georgiopoulou  1 , Andreas P Kalogeropoulos, Bruce M Psaty, Nicolas Rodondi, Douglas C Bauer, Abida B Butler, Annemarie Koster, Andrew L Smith, Tamara B Harris, Anne B Newman, Stephen B Kritchevsky, Javed Butler
Affiliations

Lung function and risk for heart failure among older adults: the Health ABC Study

Vasiliki V Georgiopoulou et al. Am J Med. 2011 Apr.

Abstract

Background: The impact of abnormal spirometric findings on risk for incident heart failure among older adults without clinically apparent lung disease is not well elucidated.

Methods: We evaluated the association of baseline lung function with incident heart failure, defined as first hospitalization for heart failure, in 2125 participants of the community-based Health, Aging, and Body Composition (Health ABC) Study (age, 73.6 ± 2.9 years; 50.5% men; 62.3% white; 37.7% black) without prevalent lung disease or heart failure. Abnormal lung function was defined either as forced vital capacity (FVC) or forced expiratory volume in 1(st) second (FEV(1)) to FVC ratio below lower limit of normal. Percent predicted FVC and FEV(1) also were assessed as continuous variables.

Results: During follow-up (median, 9.4 years), heart failure developed in 68 of 350 (19.4%) participants with abnormal baseline lung function, as compared with 172 of 1775 (9.7%) participants with normal lung function (hazard ratio [HR] 2.31; 95% confidence interval [CI], 1.74-3.07; P <.001). This increased risk persisted after adjusting for previously identified heart failure risk factors in the Health ABC Study, body mass index, incident coronary heart disease, and inflammatory markers (HR 1.83; 95% CI, 1.33-2.50; P <.001). Percent predicted (%) FVC and FEV(1) had a linear association with heart failure risk (HR 1.21; 95% CI, 1.11-1.32 and 1.18; 95% CI, 1.10-1.26, per 10% lower %FVC and %FEV(1), respectively; both P <.001 in fully adjusted models). Findings were consistent in sex and race subgroups and for heart failure with preserved or reduced ejection fraction.

Conclusions: Abnormal spirometric findings in older adults without clinical lung disease are associated with increased heart failure risk.

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Conflict of interest statement

Conflict of interest for all authors: None declared

Figures

Figure 1
Figure 1
Flowchart of participant selection for the current analysis.
Figure 2
Figure 2
Annualized risk of incident heart failure for participants with normal versus abnormal lung function tests at baseline, adjusted for predictors of heart failure and body mass index. Smoothed hazard estimate was obtained using an Epanechnikov kernel. Although the absolute annualized risk increases from year 1 to year 5 before reaching a plateau in both groups, the relative risk remains stable over time.
Figure 3
Figure 3
Kaplan-Meier rates of incident heart failure by baseline lung function status in sex and race subgroups, adjusted for predictors of heart failure and body mass index.
Figure 4
Figure 4
Unadjusted incident heart failure rates according to baseline forced expiratory volume in 1st sec (FEV1) and forced vital capacity (FVC) values. Rates are expressed in cases per 1000 person-years.
See this image and copyright information in PMC

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