Low Lung Function Is Associated with High Population Attributable Fraction for Cardiovascular Mortality.
Surya P Bhatt1, Chaoqi Wu2, Yifei Sun2
1Division of Pulmonary, Allergy, and Critical Care Medicine, Center for Lung Analytics and Imaging Research, University of Alabama at Birmingham, Birmingham, Alabama.
Annals of the American Thoracic Society
|October 24, 2024
Summary
Low lung function significantly contributes to coronary heart disease (CHD) mortality, ranking as a major risk factor. This finding highlights the importance of lung function assessment in cardiovascular risk evaluation.
Area of Science:
- Cardiology
- Pulmonology
- Epidemiology
Background:
- Chronic lung diseases are linked to increased coronary heart disease (CHD) mortality.
- The population attributable fraction (PAF) of impaired lung function for CHD mortality is not well-established.
- Understanding lung function's role in cardiovascular risk is crucial for public health.
Purpose of the Study:
- To determine the population attributable fraction (PAF) of low lung function for coronary heart disease (CHD) mortality.
- To compare the impact of low lung function with other established cardiovascular risk factors.
Main Methods:
- Pooled data from eight U.S. general population cohorts, including spirometry and clinical data.
- Defined impaired lung function as forced expiratory volume in 1 second (FEV1) and/or forced vital capacity ≤95% predicted.
- Utilized cause-specific proportional hazards and Fine-Gray models, adjusting for multiple cardiovascular risk factors and competing risks.
Main Results:
- Low FEV1 (≤95% predicted) was associated with a 1.30 hazard ratio for CHD mortality.
- The PAF for low FEV1 was 12%, positioning it as the third leading attributable risk factor for CHD mortality after hypertension and diabetes.
- In active smokers, low FEV1 accounted for 14% of CHD mortality, ranking second after hypertension.
Conclusions:
- Reduced lung function, even within clinically normal ranges, is a significant attributable risk factor for CHD mortality.
- Lung function assessment should be integrated into cardiovascular risk stratification strategies.
- This research underscores the interconnectedness of respiratory and cardiovascular health.
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