title: Relationship of peak expiratory flow rate with mortality and ischaemic heart disease in elderly Australians.
abstract: OBJECTIVE
  To evaluate the relationships of mortality and ischaemic heart disease (IHD) with peak expiratory flow rate (PEF) in the elderly.
  
  
  METHODS
  Prospective study with median follow-up of 83 months.
  
  
  METHODS
  Dubbo, a New South Wales country town (population, 30500).
  
  
  METHODS
  Non-institutionalised residents born before 1930 (i.e., aged 60 years and over at study entry). Participation rate was 73% (1235 men and 1570 women).
  
  
  METHODS
  Baseline demographic, psychosocial and standard cardiovascular risk factors, including PEF; all-causes mortality, IHD mortality and IHD events (hospitalisations with any manifestation of IHD) by tertile of PEF.
  
  
  RESULTS
  More subjects with PEF in the lowest tertile (I) had a past history of respiratory disease, were current cigarette smokers and were taking antihypertensive drugs. During follow-up, 321 men (26%) and 252 women (16%) died. All-causes mortality was three (men) to four (women) times higher for those in PEF tertile I than for those in tertile III. IHD mortality and IHD events showed similar trends. In a proportional hazards model adjusted for age, height, smoking status and other risk factors or confounders, the hazard ratios (95% confidence interval) for men in PEF tertile I versus tertile III were: all-causes mortality, 1.62 (1.14-2.30); IHD mortality, 1.75 (0.96-3.20); and IHD events, 1.12 (0.82-1.53). For women, respective hazard ratios were 1.92 (1.23-3.00), 2.58 (1.24-5.39), and 1.16 (0.83-1.63).
  
  
  CONCLUSIONS
  We confirm an independent, inverse relationship between PEF and all-causes and IHD mortality. The data suggest a potential benefit for coronary risk factor management in subjects with existing airways disease and further support the case for antismoking programs.
authors.affiliation: University of New South Wales Lipid Research Department, St Vincent's Hospital, Sydney, NSW.
authors.forename: L A
authors.initials: LA
authors.lastname: Simons
authors.forename: J
authors.initials: J
authors.lastname: McCallum
authors.forename: J
authors.initials: J
authors.lastname: Simons
authors.forename: Y
authors.initials: Y
authors.lastname: Friedlander
mesh_terms: D000368:Aged; D001315:Australia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009026:Mortality; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D010366:Peak Expiratory Flow Rate; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects