Relation Between COPD Severity and Global Cardiovascular Risk in US Adults

Lee, Hwa Mu; Lee, Janet; Lee, Katherine; Luo, Yunhua; Sin, Don D.; Wong, Nathan D.

doi:10.1378/chest.11-2421

Cited by 42 publications

(32 citation statements)

References 24 publications

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“…Numerous studies have detected a relationship between spirometric measurements and cardiovascular mortality. In a study of adults ≥40 years of age, the proportion of patients at high risk for cardiovascular events was twice as high among patients with FEV 1 <80% predicted compared to those with normal FEV 1 measurements . A low FVC and/or FEV 1 have also been found to be associated with increased cardiovascular mortality in other studies, and in a systematic meta‐analytic review of the literature …”

Section: Discussionmentioning

confidence: 94%

Exercise testing and spirometry as predictors of mortality in congenital heart disease: Contrasting Fontan physiology with repaired tetralogy of Fallot

Shafer

Opotowsky

Rhodes

2018

Congenital Heart Disease

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Variables most predictive of mortality in Fontan and TOF patients diverge but spirometry was abnormal and associated with mortality in both groups. When compared with age-matched controls, reduced FEV and FVC correlated most strongly with mortality in Fontan patients while VE/VCO slope correlated with mortality for TOF patients. These findings further support the importance of lung health in patients with complex congenital heart disease.

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Section: Discussionmentioning

confidence: 94%

Exercise testing and spirometry as predictors of mortality in congenital heart disease: Contrasting Fontan physiology with repaired tetralogy of Fallot

Shafer

Opotowsky

Rhodes

2018

Congenital Heart Disease

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“…While past studies have suggested that cholesterol is a risk factor for CVD but not COPD 15 , BMI has been previously established as an independent prognostic factor in all-cause mortality among COPD individuals 16-19 .…”

Section: Discussionmentioning

confidence: 97%

Association of lung function with coronary heart disease and cardiovascular disease outcomes in elderly: The Rancho Bernardo study

Lee

Liu

Barrett‐Connor

et al. 2014

Respiratory Medicine

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Introduction 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 1,548 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 (<3x 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<.01] and CVD [HR 0.82 (0.74-0.91) for both FEV1 and FVC, per SD, p<.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<.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.

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“…To our knowledge, this is the first study that describes all‐cause and CVD mortality rates according to extent of COPD and vitamin D deficiency. Because CVD is known as a comorbidity of COPD, vitamin D deficiency may have a direct impact on mortality . Also, although substantial studies have demonstrated the association of vitamin D and CVD, the mechanism remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Does Low Vitamin D Amplify the Association of COPD With Total and Cardiovascular Disease Mortality?

Lee

Liu

Lee

et al. 2014

Clinical Cardiology

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Background: Chronic obstructive pulmonary disease (COPD) has been shown to be associated with lower levels of vitamin D, and the latter has been associated with total and cardiovascular disease (CVD) mortality. Hypothesis: We hypothesized that lower vitamin D levels will further enhance the association of COPD and its severity with total and CVD mortality. Methods: We studied 7746 US adults age ≥40 years without known CVD (mean age, 59.8 years) and followed up through 2006 (8.2 ± 2.5 years) for total and CVD mortality. Serum 25-hydroxyvitamin D levels were categorized as tertiles: first tertile, <50.9 nm/L; second tertile, 50.9 to 73.6 nm/L; and third tertile, >73.6 nm/L. Severity of COPD was classified on the basis of forced expiratory volume per second (FEV 1 ): mild COPD (FEV 1 ≥80%) and moderate or severe COPD (FEV 1 <80%), and requires a FEV 1 /forced vital capacity ratio <70%. With Cox regression, we examined the hazard ratio (HR) and 95% confidence interval (CI) for total and CVD mortality according to COPD/vitamin D category, using those with no COPD in the first tertile of vitamin D as the reference group. Results: From Cox regression, unadjusted HRs increased successively with increasing COPD severity and decreasing vitamin D group to 4.5 (95% CI: 3.3-6.1) for total and 3.4 (95% CI: 2.2-5.3) for CVD mortality among those with moderate/severe COPD who were in the first tertile of vitamin D. After adjustment for age, sex, ethnicity, and other risk factors, these associations were attenuated but remained increased. Conclusions: Lower levels of vitamin D may be associated with further increases in total and CVD mortality associated with COPD; however, age and cardiovascular risk factors appear to explain much of this association.

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Relation Between COPD Severity and Global Cardiovascular Risk in US Adults

Cited by 42 publications

References 24 publications

Exercise testing and spirometry as predictors of mortality in congenital heart disease: Contrasting Fontan physiology with repaired tetralogy of Fallot

Exercise testing and spirometry as predictors of mortality in congenital heart disease: Contrasting Fontan physiology with repaired tetralogy of Fallot

Association of lung function with coronary heart disease and cardiovascular disease outcomes in elderly: The Rancho Bernardo study

Does Low Vitamin D Amplify the Association of COPD With Total and Cardiovascular Disease Mortality?

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