Predictive value of lung function measures for cardiovascular risk: a large prospective cohort study

Area of Science:

• Cardiology
• Pulmonology
• Epidemiology

Background:

• Cardiovascular disease (CVD) risk assessment is crucial for prevention.
• Lung function measures are known to be associated with CVD.
• The incremental predictive value of lung function for CVD risk remains under investigation.

Purpose of the Study:

• To evaluate the added predictive value of spirometry parameters for cardiovascular disease (CVD) risk.
• To assess the association between lung function impairments (restrictive and obstructive) and CVD outcomes.
• To determine the clinical utility of integrating lung function into existing CVD risk prediction models.

Main Methods:

• Analysis of 308,415 UK Biobank participants without prior CVD.
• Utilized spirometry data and CVD outcomes defined by QRISK3, ACC/AHA, and SCORE models.
• Employed Cox proportional hazard models and decision curve analyses to assess predictive capability.

Main Results:

• Over 12.5 years, spirometry parameters showed L-shaped associations with CVD.
• Restrictive and obstructive lung impairments significantly increased CVD risk across all prediction models (e.g., adjusted HRs ranging from 1.20 to 1.84).
• Integrating non-linear forced expiratory volume in 1s improved CVD risk prediction, demonstrating net benefits.

Conclusions:

• Spirometry indicators offer valuable additions to cardiovascular disease risk assessment.
• Further cost-effectiveness studies and clinical trials are warranted to implement these findings into practice.
• Clinicians should consider lung function as part of comprehensive CVD risk evaluation.