title: Association of lung function with coronary heart disease and cardiovascular disease outcomes in elderly: the Rancho Bernardo study.
abstract: BACKGROUND
  Lung function is inversely associated with coronary heart disease (CHD) and cardiovascular disease (CVD). We evaluated the prospective association of reduced lung function by spirometry and CHD or CVD events in older community-dwelling adults.
  
  
  METHODS
  We studied 1548 participants (mean age 73.6 ± 9.2 years, 42% males) from the Rancho Bernardo Study using age, sex, and risk-factor adjusted Cox regression to assess pulmonary function (FEV1, FVC, and FEV1/FVC ratio) as a predictor of CHD and CVD events followed for up to 22 years.
  
  
  RESULTS
  Of CVD risk factors, older age, male sex, current/past smoking, physical exercise (<3× a week), and prevalent CVD predicted an increased risk of CHD and CVD. Higher FEV1 and FVC were each associated with a decreased risk of CHD [HR 0.80 (0.73-0.88) for both FEV1 and FVC, per SD, p < 0.01] and CVD [HR 0.82 (0.74-0.91) for both FEV1 and FVC, per SD, p < 0.01]. Those in the lowest quartiles of FEV1 and FVC had hazard ratios of 1.68 (1.33-2.13) and 1.55 (1.21-2.00) respectively for CHD and 1.74 (1.34-2.25) and 1.49 (1.13-1.96) respectively for CVD (all p < 0.01, relative to those in the highest quartile). Similar findings were observed for CHD and CVD mortality. Sex- and age-stratified analyses showed the strongest associations for CHD and CVD events in women and in the oldest participants.
  
  
  CONCLUSIONS
  FEV1 and FVC are inversely associated with risk of future CHD and CVD events in older community-dwelling adults and may add to CVD risk stratification in the elderly.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California, Irvine, CA, USA; Heart Disease Prevention Program, University of California, Irvine, CA, USA. Electronic address: leehwamumd@gmail.com.
authors.forename: Hwa Mu
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Heart Disease Prevention Program, University of California, Irvine, CA, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Liu
authors.affiliation: Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.affiliation: Heart Disease Prevention Program, University of California, Irvine, CA, USA.
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Wong
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013147:Spirometry / Q000379:methods; D014797:Vital Capacity / Q000502:physiology
keywords: Cardiovascular disease; Coronary heart disease; Epidemiology; Pulmonary function test