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Spirometric impairments, cardiovascular outcomes, and noncardiovascular death in older persons.
Tuesday,2018-05-01 17:35 America/Los_Angeles — ecterry
| Title | Spirometric impairments, cardiovascular outcomes, and noncardiovascular death in older persons. |
| Publication Type | Journal Article |
| Year of Publication | 2018 |
| Authors | Fragoso, CAVaz, Van Ness, PH, Murphy, TE, McAvay, GJ |
| Journal | Respir Med |
| Volume | 137 |
| Pagination | 40-47 |
| Date Published | 2018 Apr |
| ISSN | 1532-3064 |
| Abstract | <p><b>BACKGROUND: </b>In prior work involving older persons, the reported associations of spirometric impairments with cardiovascular outcomes may have been confounded by age-related changes in lung function. Hence, using more age-appropriate spirometric criteria from the Global Lung Function Initiative (GLI), we have evaluated the associations of spirometric impairments, specifically restrictive-pattern and airflow-obstruction, with cardiovascular death (CV-death) and hospitalization (CV-hospitalization). In these analyses, we also evaluated the competing outcome of noncardiovascular death (nonCV-death) and calculated measures of relative and absolute risk.</p><p><b>METHODS: </b>Our study sample was drawn from the Cardiovascular Health Study (CHS), including 4232 community-dwelling white persons aged ≥65 years. Multivariable regression models included the following baseline predictors: GLI-defined restrictive-pattern and airflow-obstruction, age, male gender, obesity, waist circumference, current smoker status, ≥10 pack-years of smoking, hypertension, dyslipidemia, diabetes, and cardiovascular and cerebrovascular disease. Outcomes included adjudicated CV-death, CV-hospitalization, and nonCV-death, ascertained over 10 years of follow-up. Measures of association included hazard ratios (HRs), rate ratios (RRs), and average attributable fraction (AAF), each with 95% confidence intervals.</p><p><b>RESULTS: </b>Restrictive-pattern and airflow-obstruction were associated with CV-death (adjusted HRs: 1.57 [1.18, 2.09] and 1.29 [1.04, 1.60]) and with nonCV-death (adjusted HRs: 2.10 [1.63, 2.69] and 1.79 [1.51, 2.12]), respectively. Airflow-obstruction, but not restrictive-pattern, was also associated with CV-hospitalization (adjusted RRs: 1.18 [1.02, 1.36] and 1.20 [0.96, 1.50], respectively). The adjusted AAFs of restrictive-pattern and airflow-obstruction were 1.68% (0.46, 3.06) and 2.35% (0.22, 4.72) for CV-death, and 3.44% (1.97, 5.08) and 7.77% (5.15, 10.60) for nonCV-death, respectively.</p><p><b>CONCLUSION: </b>Assessment of GLI-defined spirometric impairments contributes to broad geriatric risk stratifications for both cardiovascular and non-cardiovascular outcomes.</p> |
| DOI | 10.1016/j.rmed.2018.02.018 |
| Alternate Journal | Respir Med |
| PubMed ID | 29605211 |
| PubMed Central ID | PMC5881905 |
| Grant List | P30 AG021342 / AG / NIA NIH HHS / United States |
ePub date:
18/04