Chest
Clinical InvestigationsThe Relationship Between Reduced Lung Function and Cardiovascular Mortality: A Population-Based Study and a Systematic Review of the Literature
Section snippets
Study Population
Originally, 20,729 Americans participated in the first National Health and Nutrition Examination Survey (NHANES) from 1971 through 1975; of these, 14,407 persons underwent a detailed medical examination. They were followed up longitudinally until 1992 as part of the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study (NHEFS).10 The data for the NHEFS were collected in four waves. The details of cohort assemblage and follow-up are provided elsewhere.10 In brief, the
NHEFS
In total, there were 1,861 adult participants in this study. The mean age of the participants was 50 ± 5.7 years; 47.1% (n = 876) were men, 9.4% (n = 174) were African-Americans, and 37.2% (n = 693) were active smokers. The mean systolic and diastolic BP values were 133.8 ± 20.2 mm Hg and 85.3 ± 11.6 mm Hg, respectively (± SD). The mean BMI was 26.0 ± 4.9 kg/m2. The clinical characteristics of the study participants in the different FEV1 quintiles are summarized in Table 1.
Overall, 19.1% (n =
Discussion
The NHANES 1 follow-up data indicate that reduced FEV1 is a marker for future cardiovascular morbidity and mortality. The relationship between reduced FEV1 and mortality from ischemic heart disease was particularly striking. Even a modest decline in FEV1 (from a mean of 109% of predicted to 88% of predicted) was associated with a fivefold increase in deaths from ischemic heart disease, independent of baseline smoking status and other potential confounding factors such as age, gender, and
References (38)
- et al.
Obstructive and restrictive lung disease and markers of inflammation: data from the Third National Health and Nutrition Examination
Am J Med
(2003) - et al.
Systemic effects in COPD
Chest
(2002) - et al.
Measurement of hepatocyte growth factor in serum and bronchoalveolar lavage fluid in patients with pulmonary fibrosis
Respir Med
(1998) - et al.
Current methods of the US Preventive Services Task Force: a review of the process
Am J Preventive Med
(2001) - et al.
Effects of pulmonary function on mortality
J Chronic Dis
(1985) - et al.
Pulmonary function is a long-term predictor of mortality in the general population: 29-year follow-up of the Buffalo Health Study
Chest
(2000) Respiratory symptoms and pulmonary function as predictors of 10-year mortality from respiratory disease, cardiovascular disease, and all causes in the Whitehall Study
J Clin Epidemiol
(1988)- et al.
The hepatocyte growth factor regulates the synthesis of acute-phase proteins in human hepatocytes: divergent effect on interleukin-6-stimulated genes
Hepatology
(1996) - et al.
Particulate air pollution induces progression of atherosclerosis
J Am Coll Cardiol
(2002) - et al.
Validation of death certificate diagnosis for coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) Study
J Clin Epidemiol
(2001)
Smoking, pulmonary function, and mortality
Ann Epidemiol
Death certificate reporting of confirmed airways obstructive disease
Am J Epidemiol
Why are patients with chronic obstructive pulmonary disease at increased risk of cardiovascular diseases? The potential role of systemic inflammation in chronic obstructive pulmonary disease
Circulation
Inflammatory response and body composition in chronic obstructive pulmonary disease
Am J Respir Crit Care Med
The relationship between chronic hypoxemia and activation of the tumor necrosis factor-α system in patients with chronic obstructive pulmonary disease
Am J Respir Crit Care Med
Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1: the Lung Health Study
JAMA
Multiple Risk Factor Intervention Trial Research Group. Multiple Risk Factor Intervention Trial: risk factor changes and mortality results
JAMA
Plan and operation of the NHANES I Epidemiologic Follow-up Study, 1992. National Center for Health Statistics
Vital Health Stat
National Center for Health Statistics
Computer-assisted spirometry data analysis for the National Health and Nutrition Examination Survey, 1971–75
Cited by (752)
Lung function and cardiovascular risk at age 45 in a cohort of the general population
2024, Respiratory MedicineSchools’ air quality monitoring for health and education: Methods and protocols of the SAMHE initiative and project
2023, Developments in the Built EnvironmentPulmonary rehabilitation and endothelial function in patients with chronic obstructive pulmonary disease: A prospective cohort study
2023, European Journal of Internal MedicineInvestigation of ocular microstructural changes according to disease severity in patients with chronic obstructive pulmonary disease
2023, Canadian Journal of OphthalmologyLung Function Decline in Young Adulthood and Coronary Artery Calcium Progression in Midlife
2023, American Journal of Medicine
Dr. Sin is supported by a Canada Research Chair (Respiration) and a Michael Smith/St. Paul's Hospital Foundation Professorship in COPD.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).