Lung function and ischemic stroke incidence: the Atherosclerosis Risk in Communities study

Area of Science:

• Cardiovascular epidemiology
• Pulmonary medicine
• Neurology

Background:

• Limited research exists on the association between lung function and ischemic stroke incidence.
• No prior studies have investigated this relationship specifically within the African American population.

Purpose of the Study:

• To investigate the association between lung function indicators and the incidence of ischemic stroke.
• To examine potential differences in this association across racial groups, specifically white subjects and African Americans.

Main Methods:

• A longitudinal study followed 13,842 middle-aged adults without prior stroke or coronary heart disease for 13 years.
• Lung function was assessed using forced expiratory volume in 1 second as a percentage of predicted value (FEV1PP) and forced vital capacity as a percentage of predicted value (FVCPP).
• Incident ischemic strokes were recorded, and statistical models were used to analyze the relationship between lung function quartiles and stroke risk, with adjustments for confounders.

Main Results:

• Initially, both FEV1PP and FVCPP showed a significant inverse relationship with ischemic stroke incidence in age-, race-, gender-, and education-adjusted models.
• For white subjects, a significant inverse association between impaired lung function and ischemic stroke risk remained after full adjustment (RH across lowest to highest FEV1PP quartiles: 1.59 to 1.00; FVCPP quartiles: 1.56 to 1.00).
• No significant association was observed for African Americans (linear trend for FEV1PP: p=0.27; FVCPP: p=0.75). The inverse relation in white subjects persisted even among never-smokers or those without respiratory symptoms, but not in African Americans.

Conclusions:

• Impaired lung function is associated with a modestly increased risk of ischemic stroke among white individuals.
• This association is evident even in white subjects who have never smoked or reported respiratory symptoms.
• The findings highlight a potential link between pulmonary health and cerebrovascular disease risk, with differing implications across racial groups.