@article {7799, title = {Impact of lung-function measures on cardiovascular disease events in older adults with metabolic syndrome and diabetes.}, journal = {Clin Cardiol}, volume = {41}, year = {2018}, month = {2018 Jul}, pages = {959-965}, abstract = {

BACKGROUND: Individuals with metabolic syndrome (MetS) and diabetes (DM) are more likely to have decreased lung function and are at greater risk of cardiovascular disease (CVD).

HYPOTHESIS: Lung-function measures can predict CVD events in older persons with MetS, DM, and neither condition.

METHODS: We followed 4114 participants age >= 65 years with and without MetS or DM in the Cardiovascular Health Study. Cox regression examined the association of forced vital capacity (FVC) and 1-second forced expiratory volume (FEV ; percent of predicted values) with incident coronary heart disease and CVD events over 12.9 years.

RESULTS: DM was present in 537 (13.1\%) and MetS in 1277 (31.0\%) participants. Comparing fourth vs first quartiles for FVC, risk of CVD events was 16\% (HR: 0.84, 95\% CI: 0.59-1.18), 23\% (HR: 0.77, 95\% CI: 0.60-0.99), and 30\% (HR: 0.70, 95\% CI: 0.58-0.84) lower in DM, MetS, and neither disease groups, respectively. For FEV , CVD risk was lower by 2\% (HR: 0.98, 95\% CI: 0.70-1.37), 26\% (HR: 0.74, 95\% CI: 0.59-0.93), and 31\% (HR: 0.69, 95\% CI: 0.57-0.82) in DM. Findings were strongest for predicting congestive heart failure (CHF) in all disease groups. C-statistics increased significantly with addition of FEV or FVC over risk factors for CVD and CHF among those with neither MetS nor DM.

CONCLUSIONS: FEV and FVC are inversely related to CVD in older adults with and without MetS, but not DM (except for CHF); however, their value in incremental risk prediction beyond standard risk factors is limited mainly to metabolically healthier persons.

}, issn = {1932-8737}, doi = {10.1002/clc.22985}, author = {Lee, Hwa Mu and Zhao, Yanglu and Liu, Michael A and Yanez, David and Carnethon, Mercedes and Graham Barr, R and Wong, Nathan D} }