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Declining Lung Function and Cardiovascular Risk: The ARIC Study.

Odilson M Silvestre1, Wilson Nadruz2, Gabriela Querejeta Roca3

  • 1Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Internal Medicine, Federal University of Acre, Rio Branco, Acre, Brazil.

Journal of the American College of Cardiology
|September 1, 2018
PubMed
Summary
This summary is machine-generated.

Rapid decline in lung function, measured by spirometry, significantly increases the risk of developing cardiovascular disease (CVD), especially heart failure (HF). This finding highlights the importance of monitoring lung health for cardiovascular risk assessment.

Keywords:
FEV(1)FVCcardiovascular diseaseheart failurelung function

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Area of Science:

  • Cardiology
  • Pulmonology
  • Epidemiology

Background:

  • Pulmonary dysfunction is a known predictor of incident cardiovascular disease (CVD).
  • Understanding the link between lung function decline and specific cardiovascular outcomes is crucial for risk stratification.

Purpose of the Study:

  • To investigate the association between longitudinal decline in lung function and the incidence of heart failure (HF), coronary heart disease (CHD), and stroke.
  • To determine if rapid changes in forced expiratory volume in 1 second (FEV1) or forced vital capacity (FVC) predict future cardiovascular events.

Main Methods:

  • Utilized data from 10,351 Atherosclerosis Risk In Communities (ARIC) study participants without prior CVD.
  • Defined rapid lung function decline as the greatest quartile of FEV1 or FVC decline over approximately 3 years.
  • Employed multivariable Cox regression to assess the relationship between rapid lung function decline and incident HF, CHD, stroke, or a composite outcome, adjusting for numerous covariates.

Main Results:

  • In a cohort with a mean age of 54 years, rapid decline in both FEV1 and FVC was significantly associated with a heightened risk of incident HF.
  • Rapid FEV1 decline showed particular prognostic value in the first year of follow-up and was also linked to an increased risk of incident stroke.
  • The study found hazard ratios for HF associated with rapid FEV1 and FVC decline of 1.17 (95% CI: 1.04-1.33) and 1.27 (95% CI: 1.12-1.44), respectively.

Conclusions:

  • A rapid decline in lung function, as measured by serial spirometry, is associated with an increased incidence of subsequent cardiovascular disease.
  • The findings strongly suggest that monitoring lung function decline can aid in identifying individuals at higher risk for developing heart failure and stroke.