Abstract 17301: Sleep Apnea is a Predictor of Incident Heart Failure in Community-Dwelling Older Adults: Findings from a Prospective Population Study
Background: Sleep apnea or disordered breathing during sleep is highly prevalent in heart failure (HF) and may be associated with poor prognosis. HF is also considered a risk factor for sleep apnea. However, it is unclear whether sleep apnea is also a risk factor and predictor of incident HF.
Methods: Of the 5795 community-dwelling adults, ≥65 years, in the Cardiovascular Health Study, 4814 were without prevalent HF and responded to the question: “Has anyone observed you while sleeping to have episodes where you stop breathing for a while and then snore or snort loudly?” Of these, 387 (8%) responded “Yes” and were considered to have self-reported sleep apnea at baseline. Cox regression models were used to estimate the associations of baseline sleep apnea with incident HF during >12 years of follow-up, adjusting for age, sex, race, income, smoking, alcohol use, self-reported general health, coronary artery disease, hypertension, diabetes, atrial fibrillation, left ventricular hypertrophy, left ventricular systolic dysfunction, body mass index, systolic and diastolic blood pressure, and serum creatinine.
Results: Participants (n=4814) had a mean (±SD) age of 73 (±6) years, 57% were women, and 16% African American. Incident HF occurred in 25% and 20% of those with and without sleep apnea (unadjusted HR, 1.44; 95% CI, 1.17–1.77; p=0.001; Figure). This association was attenuated but remained significant after multivariable adjustment (adjusted HR, 1.25; 95% CI, 1.01–1.55; p=0.041). Baseline sleep apnea had no significant association with incident acute myocardial infarction or all-cause death.
Conclusions: In community-dwelling older adults without HF, baseline self-reported sleep apnea was associated with a significant increased risk of incident HF.
- © 2010 by American Heart Association, Inc.