title: The association between lung function and fatal stroke in a community followed for 4 decades.
abstract: BACKGROUND
  Previous studies, all of <20 years of follow-up, have suggested an association between lung function and the risk of fatal stroke. This study investigates the stability of this association in a cohort followed for 4 decades.
  
  
  METHODS
  The Bergen Clinical Blood Pressure Survey was conducted in Norway in 1964-1971. The risk of fatal stroke associated with forced expiratory volume after one second (FEV(1)) was estimated with Cox proportional hazards regression, making progressive adjustment for potential confounders.
  
  
  RESULTS
  Of 5617 (84%) participants with recorded baseline FEV(1), 462 died from stroke over 152 786 subsequent person-years of follow-up according to mortality statistics of 2005; mean (SD) follow-up was 27 (12) years. An association between baseline FEV(1) (L) and fatal stroke was observed; HR=1.38 (95% CI 1.11 to 1.71) and HR=1.62 (95% CI 1.22 to 2.15) for men and women, respectively (adjusted for age and height). The findings were not explained by smoking, hypertension, diabetes, atherosclerosis, socioeconomic status, obstructive lung disease, physical inactivity, cholesterol or body mass index and persisted in subgroups of never-smokers, subgroups without respiratory symptoms and survivors of the first 20 years of follow-up. For male survivors with a valid FEV(1) at follow-up (1988-1990) (n=953), baseline FEV(1) (L) indicated a possible strong and independent association to the risk of fatal stroke after adjustments for individual changes in FEV(1) (ml/year) (HR 1.95 (95% CI 0.98 to 3.86)).
  
  
  CONCLUSIONS
  There is a consistent, independent and long-lasting association between lung function and fatal stroke, probably irrespective of changes during adult life.
authors.affiliation: Department of Geriatric Medicine Ullevaal, Institute of Clinical Medicine, Oslo University Hospital University of Oslo, Oslo, Norway. a.k.gulsvik@medisin.uio.no
authors.forename: Anne Kristine
authors.initials: AK
authors.lastname: Gulsvik
authors.forename: Amund
authors.initials: A
authors.lastname: Gulsvik
authors.forename: Eva
authors.initials: E
authors.lastname: Skovlund
authors.forename: Dag Steinar
authors.initials: DS
authors.lastname: Thelle
authors.forename: Morten
authors.initials: M
authors.lastname: Mowé
authors.forename: Sjur
authors.initials: S
authors.lastname: Humerfelt
authors.forename: Torgeir Bruun
authors.initials: TB
authors.lastname: Wyller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015986:Confounding Factors, Epidemiologic; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D006973:Hypertension / Q000401:mortality; D008137:Longitudinal Studies; D008168:Lung / Q000502:physiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology; D012959:Socioeconomic Factors; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology*; D013997:Time Factors