Lung function impairment and risk of incident heart failure: the NHLBI Pooled Cohorts Study
Year: 2022
Type: article
Abstract: AIMS: The aim is to evaluate associations of lung function impairment with risk of incident heart failure (HF). METHODS AND RESULTS: Data were pooled across eight US population-based cohorts that enrolled participants from 1987 to 2004. Participants with self-reported baseline cardiovascular disease were excluded. Spirometry was used to define obstructive [forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) <0.70] or restrictive (FEV1/FVC ≥0.70, FVC <80%) lung physiology. The incident HF was defined as hospitalization or death caused by HF. In a sub-set, HF events were sub-classified as HF with reduced ejection fraction (HFrEF; EF <50%) or preserved EF (HFpEF; EF ≥50%). The Fine-Gray proportional sub-distribution hazards models were adjusted for sociodemographic factors, smoking, and cardiovascular risk factors. In models of incident HF sub-types, HFrEF, HFpEF, and non-HF mortality were treated as competing risks. Among 31 677 adults, there were 3344 incident HF events over a median follow-up of 21.0 years. Of 2066 classifiable HF events, 1030 were classified as HFrEF and 1036 as HFpEF. Obstructive [adjusted hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.07-1.27] and restrictive physiology (adjusted HR 1.43, 95% CI 1.27-1.62) were associated with incident HF. Obstructive and restrictive ventilatory defects were associated with HFpEF but not HFrEF. The magnitude of the association between restrictive physiology and HFpEF was similar to associations with hypertension, diabetes, and smoking. CONCLUSION: Lung function impairment was associated with increased risk of incident HF, and particularly incident HFpEF, independent of and to a similar extent as major known cardiovascular risk factors.
Source: European Heart Journal
Authors: Christina M Eckhardt, Pallavi P Balte, Robert Graham Barr, Alain G Bertoni, Surya P Bhatt, Michael Cuttica, Patricia A Cassano, Paolo Chaves, David Couper, David R Jacobs, Ravi Kalhan, Richard Kronmal, Leslie Lange, Laura Loehr, Stephanie J London, George T O’Connor, Wayne Rosamond, Jason Sanders, Joseph E Schwartz, Amil Shah, Sanjiv J Shah, Lewis Smith, Wendy White, Sachin Yende, Elizabeth C Oelsner
Institutions: Columbia University, Wake Forest University Health Sciences, Wake Forest University, University of Alabama at Birmingham, Northwestern University, Cornell University, New York State University College of Human Ecology, Florida International University, University of North Carolina at Chapel Hill, University of Minnesota, University of Washington, University of Colorado Denver, National Institutes of Health, National Institute of Environmental Health Sciences, Boston University, Brigham and Women's Hospital, Tougaloo College, University of Pittsburgh, VA Pittsburgh Healthcare System
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: U.S. Department of Health and Human Services, Jackson State University, School of Medicine, Boston University, Vertex Pharmaceuticals, Strong, Framingham Heart Study, Mississippi State Department of Health, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Nursing Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, National Institute of Environmental Health Sciences, National Center for Advancing Translational Sciences, National Institute on Minority Health and Health Disparities, Intramural Research Program
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OpenAlex ID: W4224589302