Vital capacity as a predictor of cardiovascular disease: The Framingham study

Kannel, William B.; Hubert, Helen B.; Lew, Edward A.

doi:10.1016/0002-8703(83)90532-x

Cited by 168 publications

(112 citation statements)

References 9 publications

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“…In the present study, hypoxia and cor pulmonale could only account for some of this effect since the relationship was also found in subjects with mild to moderately reduced FEV1. Reduced lung function has been shown to be an independent predictor of IHD [21][22][23] and of stroke [24,25], and it is possible that the biological mechanism for development of AF could be linked to atherosclerosis via a common pathway of the development of vascular and airways disease, e.g. foetal or early childhood exposure.…”

Section: Discussionmentioning

confidence: 99%

Reduced lung function and risk of atrial fibrillation in The Copenhagen City Heart Study

Buch¹,

Friberg²,

Scharling³

et al. 2003

Eur Respir J

259

151

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Chronic obstructive pulmonary disease has been associated with a high frequency of arrhythmias. Few studies have analysed the role of reduced lung function in predicting atrial fibrillation (AF). The aim of the present study was to investigate the relationship between forced expiratory volume in one second (FEV1) and risk of first episode of AF in a prospective study.Data from 13,430 males and females without previous myocardial infarction, who participated in the Copenhagen City Heart Study, were analysed. New AF was assessed at re-examination after 5 yrs and by hospital admission for AF during a period of 13 yrs. Multivariate analyses were used with adjustment for cardiopulmonary risk factors. There were 62 new cases of AF at 5-yr follow-up (0.58%) and 290 cases (2.20%) diagnosed at hospitalisations.Risk of new AF at re-examination was 1.8-times higher for FEV1 between 60-80% of predicted compared with FEV1 o80% after adjustment for sex, age, smoking, blood pressure, diabetes and body mass index. The risk of AF hospitalisation was 1.3-times higher for FEV1 between 60-80% and 1.8-times higher for FEV1 v60% compared with FEV1 o80%, when additional adjustment was made for education, treatment with diuretics and chest pain at activity.The authors conclude that reduced lung function is an independent predictor for incident atrial fibrillation. The Copenhagen City Heart Study was funded by the Danish Heart Foundation. P. Buch was the recipient of a Danish Heart Foundation introduction grant (01-1-9-F3-22880).Chronic obstructive pulmonary disease (COPD) has been associated with a high frequency of cardiac arrhythmias. Hypoxaemia [1, 2], acidosis [3], cor pulmonale and coexisting ischaemic heart disease (IHD) [4,5] have been proposed as major causes for the relationship between COPD and arrhythmias. The risk of arrhythmias in patients with COPD is influenced by the state of the disease, with a higher frequency of supraventricular tachycardia during exacerbations [1, 2, 5]. However, even in patients with stable COPD the incidence of cardiac arrhythmias is considerable [6], and, in clinical practice, it is not uncommon to find atrial fibrillation (AF) in patients hospitalised for COPD. AF is by far the most common arrhythmia in the elderly population but only a few studies have analysed the relationship between lung function and the risk of developing AF in detail. It is important to investigate the correlation between reduced lung function and AF since the incidence of COPD is expected to increase considerably in the future, reflecting prior smoking habits of an ageing population [7,8]. The aim of the present study, therefore, was to investigate the role of reduced lung function in development of AF based on a representative sample of the general population free of IHD at baseline. Methods Study populationThis study was based on data from the Copenhagen City Heart Study (CCHS). The original cohort of CCHS comprised a random age-stratified sample of 19,329 males and females aged o20 yrs from an area of Copenha...

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Section: Discussionmentioning

confidence: 99%

Reduced lung function and risk of atrial fibrillation in The Copenhagen City Heart Study

Buch¹,

Friberg²,

Scharling³

et al. 2003

Eur Respir J

259

151

View full text Add to dashboard Cite

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“…However, despite this limitation, the associations between FVC, cardiovascular risk factors, and cardiovascular mortality were similar to the results reported from other studies. 3 Although inferior precision may have influenced the validity, it is likely that splitting the cohort into quartiles of FVC reduced the degree of misclassification.…”

Section: Discussionmentioning

confidence: 99%

“…10,22 These risk factors have also been associated with reduced lung function. 3,23 Men with a history of myocardial infarction and stroke were excluded from the analysis. Angina pectoris and the major cardiovascular risk factors were taken into account in the analysis.…”

Section: Discussionmentioning

confidence: 99%

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Lung Function and Cardiovascular Risk

et al. 2002

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Background-The inverse relationship between pulmonary function and incidence of cardiovascular disease remains largely unexplained. This prospective study explored the hypothesis of a relationship with inflammation-sensitive plasma proteins. Methods and Results-Forced vital capacity (FVC) and plasma levels of fibrinogen, ␣ 1 -antitrypsin, haptoglobin, ceruloplasmin, and orosomucoid were determined in 5064 healthy men aged 28 to 61 years. All-cause mortality, cardiovascular mortality, and incidence of myocardial infarction were monitored over a mean follow-up period of 18.4 years. Low FVC (fourth quartile) was associated with higher protein levels and with increased incidences of myocardial infarction and cardiovascular death. Adjustments for protein levels reduced the age-adjusted relative risks (RRs) for myocardial infarction (from 1.99, 95% CI 1.5 to 2.6, to 1.70, 95% CI 1.3 to 2.2) and cardiovascular death (from 2.71, 95% CI 1.9 to 3.9, to 2.28, 95% CI 1.6 to 3.3) among men with low FVC, corresponding to Ϸ25% of the excess risk.The risk factor-adjusted RRs were reduced from 1.45 (95% CI 1.1 to 1.9) to 1.38 (95% CI 1.1 to 1.8) and from 1.96 (95% CI 1.4 to 2.8) to 1.85 (95% CI 1.3 to 2.7) for myocardial infarction and cardiovascular death, respectively, corresponding to Ϸ10% to 15% of the excess risk. Among men with low FVC, the risk factor-adjusted RR for myocardial infarction was 2.5 (95% CI 1.7 to 3.6) for those with high protein levels (Ն2 proteins in top quartile) and 1.7 (95% CI 1.1 to 2.4) for those with low protein levels (Յ1 protein in top quartile; reference, top quartile of FVC and low protein levels). Conclusions-FVC is significantly and inversely associated with plasma levels of inflammation-sensitive plasma proteins.This relationship contributes to but cannot fully explain the increased cardiovascular risk among men with low FVC.

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“…7 Impaired pulmonary function is clinically relevant as it is associated with increased morbidity and mortality rates. [8][9][10] Several factors may contribute to age-dependent decline of lung function.…”

Section: Introductionmentioning

confidence: 99%

Body composition and pulmonary function in the elderly: a 7-year longitudinal study

et al. 2008

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Objective: To evaluate over a 7-year follow-up period the relationships between changes in body composition, fat distribution and pulmonary function in a sample of elderly men and women. Design: Longitudinal clinical study. Subjects: A total of 47 women and 30 men aged 71.6±2.3 and 71.7±2.2 years, respectively, at baseline with body mass index (BMI) values of 24.96 ± 3.28 and 27.04 ± 3.35 kg m À2 were followed for 7 years. Measurements: Body weight, waist circumference, sagittal abdominal diameter (SAD), fat-free mass (FFM) and fat mass as measured by dual energy X-ray absorptiometry (DXA) and forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) by spirometry were evaluated at baseline and after a 7-year mean follow-up. Results: In women as in men there were no significant changes in weight, SAD and BMI. A significant decrease in height and FFM was observed in both women and men. Height-adjusted FEV1 and FVC decreased significantly in women and men over the 7-year follow-up. Changes in SAD were the most powerful predictors of 7-year follow-up of FEV1 and FVC after taking into account, respectively, baseline FEV1 and FVC. Linear regression analysis, performed by using 7-year follow-up lung function variables as dependent variables and changes in body composition variables as independent variables, showed that 1 cm SAD increase predicted a decrease in FEV1 and FVC of 31 and 46 ml, respectively, and 1 kg FFM decrease predicted a decrease in FVC of 38 ml. After subdividing our study population into four categories of change in FFM and SAD, patients with decreased FFM and increased SAD showed the highest probability of having a worsening in FEV1 and FVC. Conclusion: Increase in abdominal fat and FFM decline are significant predictors of lung function decline in the elderly. Old subjects developing both abdominal fat gain and FFM loss show the highest probability of developing worsening in lung function.

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Vital capacity as a predictor of cardiovascular disease: The Framingham study

Cited by 168 publications

References 9 publications

Reduced lung function and risk of atrial fibrillation in The Copenhagen City Heart Study

Reduced lung function and risk of atrial fibrillation in The Copenhagen City Heart Study

Lung Function and Cardiovascular Risk

Body composition and pulmonary function in the elderly: a 7-year longitudinal study

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