title: Pulmonary function is a long-term predictor of mortality in the general population: 29-year follow-up of the Buffalo Health Study.
abstract: OBJECTIVE
  Results from several studies have described a relationship between pulmonary function and both all-cause and cause-specific mortality. The purpose of this study was to investigate the predictive value of pulmonary function by gender after 29 years of follow-up.
  
  
  METHODS
  Prospective study with 29-year follow-up of the Buffalo Health Study cohort.
  
  
  METHODS
  Randomly selected sample of 554 men and 641 women, aged 20 to 89 years, from all listed households of the city of Buffalo, NY.
  
  
  RESULTS
  Baseline measurements were performed in 1960 to 1961. Pulmonary function was assessed based on FEV(1) expressed as the normal percent predicted (FEV(1)%pred). FEV(1)%pred adjusted by age, body mass index, systolic BP, education, and smoking status was inversely related to all-cause mortality in both men and women (p<0.01). A sequential survival analysis in participants who had a survival time of at least 5, 10, 15, 20, and 25 years after enrollment in the study was also performed. Except for men who survived for > 25 years, we observed a statistically significant negative association between FEV(1)%pred and all-cause mortality. FEV(1)%pred was also inversely related to ischemic heart disease (IHD) mortality. When participants were divided into quintiles of FEV(1)%pred, participants in the lowest quintile of FEV(1)%pred experienced significantly higher all-cause mortality compared with participants in the highest quintile of FEV(1)%pred. For the entire follow-up period, the adjusted hazard ratios for all-cause mortality were 2.24 (95% confidence interval [CI], 1.60 to 3.13) for men and 1. 81 (95% CI, 1.24 to 2.63) for women, respectively. Hazard ratios for death from IHD in the lowest quintile of FEV(1)%pred were 2.11 (95% CI, 1.20 to 3.71) and 1.96 (95% CI, 0.99 to 3.88) for men and women, respectively.
  
  
  CONCLUSIONS
  These results suggest that pulmonary function is a long-term predictor for overall survival rates in both genders and could be used as a tool in general health assessment.
authors.affiliation: Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, NY 14214-3000, USA. HJS@Buffalo.edu
authors.forename: H J
authors.initials: HJ
authors.lastname: Schünemann
authors.forename: J
authors.initials: J
authors.lastname: Dorn
authors.forename: B J
authors.initials: BJ
authors.lastname: Grant
authors.forename: W
authors.initials: W
authors.lastname: Winkelstein
authors.forename: M
authors.initials: M
authors.lastname: Trevisan
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality* / Q000503:physiopathology; D009518:New York / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012129:Respiratory Function Tests; D017678:Sex Distribution; D015996:Survival Rate / Q000639:trends