FEV1 and total Cardiovascular mortality and morbidity over an 18 years follow-up Population-Based Prospective EPIC-NORFOLK Study.
Lentjes, Marleen AH
BMC public health
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Ching, S., Chia, Y., Lentjes, M. A., Luben, R., Wareham, N., & Khaw, K. (2019). FEV1 and total Cardiovascular mortality and morbidity over an 18 years follow-up Population-Based Prospective EPIC-NORFOLK Study.. BMC public health, 19 (1), 501. https://doi.org/10.1186/s12889-019-6818-x
BACKGROUND: Our study aimed to determine the association between forced expiratory volume in one second (FEV1) and subsequent fatal and non-fatal events in a general population. METHODS: The Norfolk (UK) based European Prospective Investigation into Cancer (EPIC-Norfolk) recruited 25,639 participants between 1993 and 1997. FEV1 measured by portable spirometry, was categorized into sex-specific quintiles. Mortality and morbidity from all causes, cardiovascular disease (CVD) and respiratory disease were collected from 1997 up to 2015. Cox proportional hazard regression analysis was used with adjustment for socio-economic factors, physical activity and co-morbidities. RESULTS: Mean age of the population was 58.7 ± 9.3 years, mean FEV1 for men was 294± 74 cL/s and 214± 52 cL/s for women. The adjusted hazard ratios for all-cause mortality for participants in the highest fifth of the FEV1 category was 0.63 (0.52, 0.76) for men and 0.62 (0.51, 0.76) for women compared to the lowest quintile. Adjusted HRs for every 70 cL/s increase in FEV1 among men and women were 0.77 (p < 0.001) and 0.68 (p < 0.001) for total mortality, 0.85 (p<0.001) and 0.77 (p<0.001) for CVD and 0.52 (p <0.001) and 0.42 (p <0.001) for respiratory disease. CONCLUSIONS: Participants with higher FEV1 levels had a lower risk of CVD and all-cause mortality. Measuring the FEV1 with a portable handheld spirometry measurement may be used as a surrogate marker for cardiovascular risk. Every effort should be made to identify those with poorer lung function even in the absence of cardiovascular disease as they are at greater risk of total and CV mortality.
Humans, Neoplasms, Respiratory Tract Diseases, Cardiovascular Diseases, Respiratory Function Tests, Vital Capacity, Forced Expiratory Volume, Spirometry, Morbidity, Proportional Hazards Models, Risk Factors, Cohort Studies, Follow-Up Studies, Prospective Studies, Comorbidity, Research Design, Adult, Aged, Middle Aged, Female, Male, Coronary Artery Disease
This work was supported by a Sabbatical programme awarded to Ching SM by Universiti Putra Malaysia. European Prospective Investigation into Cancer–Norfolk is funded by grants from the Medical Research Council UK (G9502233, G0401527) and Cancer Research UK (C864/A8257, C864/A2883). We further acknowledge core MRC Epidemiology Unit support through Programmes MC_UU_12015/1 and MC_UU_12015/5.
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
Cancer Research UK (A8257)
Cancer Research UK (A2883)
MEDICAL RESEARCH COUNCIL (MR/N003284/1)
External DOI: https://doi.org/10.1186/s12889-019-6818-x
This record's URL: https://www.repository.cam.ac.uk/handle/1810/292858
Attribution 4.0 International
Licence URL: https://creativecommons.org/licenses/by/4.0/