Impact of Lung Function and SDB on Incident Myocardial Infarction and Heart Failure: A Community-based Study

Purpose: To investigate whether lung function, especially when complicated with SDB, has an increased risk for myocardial infarction (MI) and congestive heart failure (CHF). Methods: A prospective study was performed within the Sleep Heart Health Study (SHHS). A total of 4161 individuals were followed up for an average of 10.91 years. Forced vital capacity (FVC), forced expiratory volume in one second (FEV₁) and the predicted value of FVC and FEV₁ were measured to evaluate lung function. The primary outcomes were the MI and CHF. Cox regression analysis was used to investigate the association between reduced lung function and the incidence of MI or CHF. In subgroup analysis, all the individuals were divided into Apnoea–Hypopnoea Index (AHI) < 5 subgroup and AHI ≥ 5 subgroup to explore the relationship. Results: Lung function were inversely associated with the incidence of MI or CHF. The hazard ratio (HR) and 95% confidence interval (95% CI) for MI and CHF were 0.658 (0.543–0.797) and 0.792 (0.673–0.933) for every 1 L increase in FVC, 0.715 (0.567–0.902) and 0.738 (0.605–0.900) for every 1 L increase in FEV₁, 0.986 (0.979–0.993) and 0.989 (0.983–0.995) for every 1% increase in FEV₁/pre%, and 0.994 (0.988–0.999) and 0.991 (0.987–0.996) in FVC/pre%, respectively. In addition, the association of lung function with MI and CHF was more prominent in the subgroup with AHI ≥ 5. Conclusions: Lung function may be associated with incident MI and CHF in this large community cohort of middle-aged and older adults, especially in those with SDB.