title: Lung function and risk for heart failure among older adults: the Health ABC Study.
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.
authors: Department of Medicine, Emory University, Atlanta, GA, USA. vgeorgi@emory.edu
authors: Vasiliki V
authors: VV
authors: Georgiopoulou
authors: Andreas P
authors: AP
authors: Kalogeropoulos
authors: Bruce M
authors: BM
authors: Psaty
authors: Nicolas
authors: N
authors: Rodondi
authors: Douglas C
authors: DC
authors: Bauer
authors: Abida B
authors: AB
authors: Butler
authors: Annemarie
authors: A
authors: Koster
authors: Andrew L
authors: AL
authors: Smith
authors: Tamara B
authors: TB
authors: Harris
authors: Anne B
authors: AB
authors: Newman
authors: Stephen B
authors: SB
authors: Kritchevsky
authors: Javed
authors: J
authors: Butler
mesh_terms: D000368:Aged; D015415:Biomarkers; D005260:Female; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D007249:Inflammation / Q000097:blood; D008171:Lung Diseases / Q000150:complications*; D008297:Male; D017063:Outcome Assessment, Health Care; D044469:Racial Groups; D012307:Risk Factors; D012727:Sex Characteristics
chemical_list: D015415:Biomarkers