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

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 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 (<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 < 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. (C) 2014 Elsevier Ltd. All rights reserved.