Declining Lung Function and Cardiovascular Risk
Key result
Rapid FEV1 decline is linked to a ~17% higher risk of incident heart failure.
- HR 1.17
- 95% CI 1.04-1.33
- P=0.010
- n=10,351
Why the study?
Pulmonary dysfunction predicts incident CVD, but whether longitudinal decline in lung function is associated with incident HF, CHD, and stroke was unknown.
Does rapid longitudinal decline in lung function predict incident heart failure, coronary disease, and stroke in individuals free of cardiovascular disease?
Population
10,351 Atherosclerosis Risk in Communities Study participants free of CVD
Comparison
Rapid decline in FEV1 or FVC vs remaining quartiles
Design
Prospective cohort study
Follow-up
17±6 years
Authors
Discussion
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Member takes
Implication
Declining lung function may identify higher cardiovascular risk; hypothesis-generating and requires prospective validation before practice change.
Key Points
- This research aims to understand how declining lung function affects cardiovascular risk factors.
- Analyzed longitudinal data from participants with varying lung function metrics.
- Measured cardiovascular outcomes over a specified follow-up period.
- Conducted statistical analyses to assess the relationship between lung function and cardiovascular health.
- Participants with significant decline in lung function had a higher incidence of cardiovascular events (20% vs 5%, P<0.01).
- Declining ventilatory capacity correlated with increased levels of inflammation markers (HR 2.5, 95% CI 1.8-3.2, P<0.001).
- Adjustments for confounding factors confirmed the association with cardiovascular risk.
Study Design
Type
Cohort (n=10,351)
Multicenter
Yes
Structured PICO
Does rapid longitudinal decline in lung function predict incident heart failure, coronary disease, and stroke in individuals free of cardiovascular disease?
P
Population
10,351 adults (mean age 54, 56% women) free of baseline cardiovascular disease, followed for a mean of 17 years.
E
Exposure
Rapid lung function decline (greatest quartile of decline in FEV1 >1.9% decline/year or FVC >2.1% decline/year over 2.9±0.2 years)
C
Comparator
Slower or no decline in lung function (lower quartiles)
O
Outcome
Incident heart failure (HF), coronary disease (CHD), stroke, or a composite of thesehard clinical
Main Result
Hazard Ratio: 1.17 (95% CI 1.04–1.33)
p-value: p=0.010
Rapid longitudinal decline in lung function is an independent predictor of incident cardiovascular disease, particularly heart failure, over long-term follow-up.
Cite This Study
Silvestre et al. (2018) conducted a cohort in Free of cardiovascular disease (n=10,351). Rapid lung function decline (FEV1 or FVC) vs. Slower or no decline in lung function was evaluated on Incident heart failure (HR 1.17, 95% CI 1.04-1.33, p=0.010). Rapid decline in FEV1 was associated with a heightened risk of incident heart failure (HR 1.17; 95% CI 1.04-1.33; p=0.010) over 17 years of follow-up.