Relationship of peak expiratory flow rate with mortality and ischaemic heart disease in elderly Australians.
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.
Simons
L A
LA
University of New South Wales Lipid Research Department, St Vincent's Hospital, Sydney, NSW.
McCallum
J
J
Simons
J
J
Friedlander
Y
Y
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