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Pulmonary function decline and 17-year total mortality: the Honolulu Heart Program

B L Rodriguez1, K Masaki, C Burchfiel

  • 1Honolulu Heart Program, Kuakini Medical Center, HI 96817.

American Journal of Epidemiology
|September 1, 1994
PubMed
Summary
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A faster rate of decline in forced expiratory volume in 1 second (FEV1) predicts higher total mortality in smokers. This lung function decline is a significant risk factor for death, especially in those with a history of smoking.

Area of Science:

  • Pulmonary Medicine
  • Epidemiology
  • Gerontology

Background:

  • The Honolulu Heart Program is an ongoing study of Japanese-American men.
  • Forced expiratory volume in 1 second (FEV1) is a key measure of lung function.
  • Understanding factors predicting mortality is crucial for public health.

Purpose of the Study:

  • To investigate the association between the rate of decline in FEV1 and total mortality.
  • To determine if FEV1 decline is an independent predictor of mortality in a cohort of Japanese-American men.

Main Methods:

  • Longitudinal cohort study of 4,000 Japanese-American men aged 45-68.
  • FEV1 measured between 1965-1974; rate of change (slope) calculated using linear regression.
  • 17 years of follow-up; mortality data analyzed using Cox proportional hazards models, adjusting for covariates.

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Main Results:

  • A faster rate of FEV1 decline was significantly associated with increased total mortality (p < 0.0001).
  • Men in the highest tertile of FEV1 decline had a 48% higher risk of death (RR=1.48, 95% CI 1.24-1.77) compared to those with the smallest change.
  • The association remained significant for past smokers and across different pack-year groups, but not for never smokers.

Conclusions:

  • The rate of decline in FEV1 is a significant predictor of total mortality, particularly among smokers.
  • Lung function decline may serve as an early warning sign for increased mortality risk in smoking populations.
  • Further research could explore mechanisms linking FEV1 decline to mortality in smokers.