Rapid decline in lung function tied to higher CVD risk
A declining lung function, assessed by serial spirometry, may result in a higher incidence of subsequent cardiovascular disease (CVD), particularly incident heart failure (HF), suggests a recent study.
In the ARIC (Atherosclerosis Risk In Communities) study, 20,351 participants (mean age 54±6 years; 56 percent women; 81 percent white) free of CVD were included. Among these, rapid lung function decline was defined as the greatest quartile (n=2,585) of decline in either forced expiratory volume in 1 s (FEV1; >1.9-percent decline/year) or forced vital capacity (FVC; >2.1-percent decline/year) over 2.9±0.2 years.
The authors evaluated the relationship between rapid decline in FEV1 or FVC and subsequent incident HF, coronary heart disease (CHD), stroke or a composite of these using multivariable Cox regression adjusting for the baseline spirometry value, demographics, height, body mass index, heart rate, diabetes, hypertension, low-density lipoprotein, use of lipid-lowering medication, N-terminal fragment of prohormone for B-type natriuretic peptide and smoking.
HF occurred in 14 percent, CHD in 11 percent, stroke in 6 percent and the composite in 24 percent during 17±6 years of follow-up.
An association was observed between a rapid decline in FEV1 and in FVC and a heightened risk of incident HF (hazard ratio [HR], 1.17; 95 percent CI, 1.04–1.33; p=0.010 and HR, 1.27; 1.12–1.44; p<0.001; respectively), with a rapid decline in FEV1 most prognostic in the first year of follow-up (HR, 4.22; 1.34–13.26; p=0.01). Additionally, rapid decline in FEV1 correlated with incident stroke (HR, 1.25; 1.04–1.50; p=0.015).