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Low Lung Function Is Associated with High Population Attributable Fraction for Cardiovascular Mortality.
Tuesday,2025-04-08 14:40 America/Los_Angeles — ecterry
| Title | Low Lung Function Is Associated with High Population Attributable Fraction for Cardiovascular Mortality. |
| Publication Type | Journal Article |
| Year of Publication | 2025 |
| Authors | Bhatt, SP, Wu, C, Sun, Y, Balte, PP, Schwartz, JE, Divo, MJ, Jaeger, BC, Chaves, PH, Couper, D, Jacobs, DR, Lloyd-Jones, D, Kalhan, R, Newman, AB, O'Connor, GT, Umans, JG, White, WB, Yende, S, Oelsner, EC |
| Journal | Ann Am Thorac Soc |
| Volume | 22 |
| Issue | 3 |
| Pagination | 359-366 |
| Date Published | 2025 Mar |
| ISSN | 2325-6621 |
| Keywords | Adult, Aged, Coronary Disease, Female, Forced Expiratory Volume, Humans, Lung, Lung Diseases, Male, Middle Aged, Proportional Hazards Models, Risk Factors, Smoking, Spirometry, United States, Vital Capacity |
| Abstract | <p> Chronic lung diseases are associated with increased risk of mortality due to coronary heart disease (CHD). Nonetheless, the population attributable fraction (PAF) of lung function impairment relative to other established cardiovascular risk factors is unclear. To evaluate the PAF of low lung function for CHD mortality We harmonized and pooled lung function and clinical data across eight U.S. general population cohorts. Impaired lung function was defined as forced expiratory volume in 1 second (FEV) and/or forced vital capacity ≤ 95% predicted on baseline spirometry. The association between CHD mortality and risk factors was assessed using cause-specific proportional hazards and Fine-Gray proportional subdistribution hazard models, treating non-CHD mortality as a competing risk. Models were adjusted for lung function as well as age, sex, race/ethnicity, educational attainment, body mass index, smoking status, pack-years of smoking, diabetes mellitus, high-density lipoprotein, and high low-density lipoprotein (≥130 mg/dl). PAF was calculated as the relative change in the average absolute risk of 10-year CHD mortality by elimination of lung function lower than 95% predicted. Among 35,143 participants, 1,844 of 13,174 (14.0%) deaths were due to CHD. Compared with percentage predicted FEV (FEVpp) > 95%, the subdistribution adjusted hazard ratio for low FEVpp was 1.30 (95% confidence interval, 1.18-1.44). The PAF for FEVpp ≤ 95% was 12%, ranking low FEV third on the list of PAF for CHD mortality, after hypertension and diabetes. Low FEVpp ranked second in the subgroup of active smokers (PAF 14%), after hypertension. Low lung function, even in the range considered clinically normal, ranks high on the list of attributable risk factors for CHD mortality and should be considered in cardiovascular risk stratification.</p> |
| DOI | 10.1513/AnnalsATS.202407-715OC |
| Alternate Journal | Ann Am Thorac Soc |
| PubMed ID | 39447115 |
| PubMed Central ID | PMC11892675 |
| Grant List | 75N92023D00005 / GF / NIH HHS / United States N01HC95160 / HL / NHLBI NIH HHS / United States U01 HL041654 / HL / NHLBI NIH HHS / United States U01 HL130114 / HL / NHLBI NIH HHS / United States R01 HL077612 / HL / NHLBI NIH HHS / United States 75N92023D00002 / HL / NHLBI NIH HHS / United States RC1 HL100543 / HL / NHLBI NIH HHS / United States 75N92023D00003 / HL / NHLBI NIH HHS / United States HHSN268201700004C / HL / NHLBI NIH HHS / United States 75N92023D00006 / HL / NHLBI NIH HHS / United States R01 HL151421 / HL / NHLBI NIH HHS / United States HHSN268201800012C / HL / NHLBI NIH HHS / United States U01 HL041642 / HL / NHLBI NIH HHS / United States N01HC95163 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States HHSN268201500001C / HL / NHLBI NIH HHS / United States HHSN268201800014I / HB / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States 75N92023D00005 / HL / NHLBI NIH HHS / United States N01HC95169 / HL / NHLBI NIH HHS / United States N01HC95164 / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States U01 HL041652 / HL / NHLBI NIH HHS / United States HHSN268201800014C / HL / NHLBI NIH HHS / United States N01HC95162 / HL / NHLBI NIH HHS / United States R01 NR012459 / NR / NINR NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States R01 HL093081 / HL / NHLBI NIH HHS / United States N01HC95168 / HL / NHLBI NIH HHS / United States R01 HL109315 / HL / NHLBI NIH HHS / United States HHSN268201700002C / HL / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States HHSN268201800001C / HL / NHLBI NIH HHS / United States HHSN268201700001I / HL / NHLBI NIH HHS / United States HHSN268201800013I / MD / NIMHD NIH HHS / United States 75N92023D00004 / HL / NHLBI NIH HHS / United States HHSN268201700004I / HL / NHLBI NIH HHS / United States R21 HL165405 / HL / NHLBI NIH HHS / United States N01HC95165 / HL / NHLBI NIH HHS / United States N01HC95159 / HL / NHLBI NIH HHS / United States HHSN268201500001I / HL / NHLBI NIH HHS / United States HHSN268201800012I / HL / NHLBI NIH HHS / United States R21 HL129924 / HL / NHLBI NIH HHS / United States N01HC95161 / HL / NHLBI NIH HHS / United States R01 HL109319 / HL / NHLBI NIH HHS / United States HHSN268201800011C / HL / NHLBI NIH HHS / United States R01 AG028050 / AG / NIA NIH HHS / United States R01 HL109284 / HL / NHLBI NIH HHS / United States HHSN268201700005C / HL / NHLBI NIH HHS / United States HHSN268201700001C / HL / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC95167 / HL / NHLBI NIH HHS / United States HHSN268201700003C / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC25195 / HL / NHLBI NIH HHS / United States U01 HL065521 / HL / NHLBI NIH HHS / United States HHSN268201800015I / HB / NHLBI NIH HHS / United States HHSN268201700002I / HL / NHLBI NIH HHS / United States R01 HL155576 / HL / NHLBI NIH HHS / United States HHSN268201800010I / HB / NHLBI NIH HHS / United States HHSN268201700005I / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01HC95166 / HL / NHLBI NIH HHS / United States K23 HL130627 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States HHSN268201800011I / HB / NHLBI NIH HHS / United States 75N92023D00002 / GF / NIH HHS / United States R01 HL109301 / HL / NHLBI NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States HHSN268201700003I / HL / NHLBI NIH HHS / United States R01 HL109282 / HL / NHLBI NIH HHS / United States U01 HL065520 / HL / NHLBI NIH HHS / United States R01 HL157634 / HL / NHLBI NIH HHS / United States 75N92023D00004 / GF / NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States R21 HL156228 / HL / NHLBI NIH HHS / United States UH3 HL155806 / HL / NHLBI NIH HHS / United States |
ePub date:
25/03