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FEV 1 and FVC as robust risk factors for cardiovascular disease and mortality: Insights from a large population study

Respiratory medicine, 2024-04, Vol.227 [Peer Reviewed Journal]

ISSN: 1532-3064 ;ISSN: 0954-6111 ;EISSN: 1532-3064 ;DOI: 10.1016/j.rmed.2024.107614

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  • Title:
    FEV 1 and FVC as robust risk factors for cardiovascular disease and mortality: Insights from a large population study
  • Author: Rydell, Andreas ; Janson, Christer ; Lisspers, Karin ; Lin, Yi-Ting ; Ärnlöv, Johan
  • Subjects: Cardiovascular disease ; FEV ; FVC ; Mortality ; Population attributable fraction
  • Is Part Of: Respiratory medicine, 2024-04, Vol.227
  • Description: INTRODUCTION: Data is limited on influence of forced expiratory volume in 1 s (FEV 1 ) and forced vital capacity (FVC) in a large adult population, including individuals with normal spirometry at baseline. METHODS: Using the UK Biobank cohort, a multivariable Cox regression analysis was conducted on 406,424 individuals to examine the association between FEV 1 and FVC, categorized into three groups based on their percentage of predicted values (%pred) (≥80, 60-80 and < 60), and overall mortality, cardiovascular mortality, myocardial infarction, stroke, and heart failure over approximately 12.5 years. Moreover, a subgroup analysis was conducted on 295,459 individuals who had normal spirometry. RESULTS: Reduced FEV 1 and FVC %pred values were associated with an elevated risk across all studied outcomes. Individuals with the lowest FEV 1 and FVC %pred values (<60 %) exhibited HR of 1.83 (95 % CI 1.74-1.93) and 1.98 (95 % CI 1.76-2.22) for overall mortality, and 1.96 (95 % CI 1.83-2.1) and 2.26 (95 % CI 1.94-2.63) for cardiovascular mortality. Moreover, a graded association was observed between lower FEV 1 and FVC %pred, even among never smokers and individuals with normal spirometry at baseline. DISCUSSION: Reduced FEV 1 and FVC represent robust risk factors for cardiovascular disease and mortality. The fact that the increased risk was evident also at FEV 1 and FVC levels exceeding 80 %pred challenges the contemporary classification of lung function categories and the notion that the entire FEV 1 - and FVC-range above 80 % of predicted represents a normal lung function.
  • Language: English
  • Identifier: ISSN: 1532-3064
    ISSN: 0954-6111
    EISSN: 1532-3064
    DOI: 10.1016/j.rmed.2024.107614
  • Source: SWEPUB Freely available online
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