Population-based study of lung function and incidence of heart failure hospitalisations

Reduced forced expiratory volume (FEV(1)) and forced vital capacity (FVC) are risk factors for myocardial infarction (MI) and stroke. However, the relationship with incidence of heart failure (HF) is incompletely known. This population-based study explored whether reduced FEV(1) or FVC is associated with the incidence of hospitalisation for HF.

20 998 men (mean age 43 years) with no history of MI or stroke were examined with spirometry in 1974-84. The incidence of hospitalisation due to HF was studied over a mean follow-up of 23 years in relation to age- and height-adjusted FEV(1) and FVC.

725 incident HF hospitalisations occurred during the follow-up period, 503 of them without a previous or concurrent diagnosis of MI. In non-smokers the risk factor-adjusted hazard ratio (HR) for HF hospitalisation was 1.25 (95% CI 1.11 to 1.40) and 1.26 (95% CI 1.13 to 1.42), respectively, per 1SD lower FEV(1) and FVC. The corresponding risk factor-adjusted HRs in smokers were 1.32 (95% CI 1.21 to 1.45) and 1.22 (95% CI 1.11 to 1.33), respectively, for FEV(1) and FVC. This relationship was consistent in men with and without hypertension, in men above and below the median age of 44 years and for HF events without previous or concurrent MI. Exclusion of cases with a diagnosis of chronic obstructive pulmonary disease during the follow-up period did not substantially change the results.

In this long-term population-based study of men, moderately reduced FEV(1) and FVC were associated with an increased incidence of hospitalisations due to HF.