Level of FEV1as a predictor of all-cause and cardiovascular mortality: an effect beyond smoking and physical fitness?

In 1970, Higgins and Keller 1 showed that low spirometric values predict mortality independently of smoking in the general population of Tecumseh, MI, USA. Furthermore, in the general population of Renfrew and Paisley, Scotland, a forced expiratory volume in one second (FEV1) level in the lowest quintile explains a substantial fraction of all-cause mortality occurring in the subsequent 15 yrs (31% in males and 26% in females) 2. This observation was mainly mediated through a higher risk of dying from cardiovascular conditions, as it has also been observed in a number of other cohorts. In line with this, a significant association has also been reported between baseline levels of lung function and the incidence of coronary heart disease 3 and stroke 4; and, furthermore, annual decline of FEV1, independent of baseline FEV1, has also been related to cardiovascular mortality 5. Recent evidence suggests that individuals in the community with moderate airflow limitation may have co-existing systemic inflammation 6, and …