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FEV1 and FVC as robust risk factors for cardiovascular disease and mortality: Insights from a large population study.
Karolinska Institutet, Huddinge; Centrum För Klinisk Forskning, Region Dalarna, Falun,.
Uppsala University, Uppsala.
Uppsala University, Uppsala.
Karolinska Institutet, Huddinge.
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2024 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 227, article id 107614Article in journal (Refereed) Published
Sustainable development
SDG 3: Good health and well-being
Abstract [en]

INTRODUCTION: Data is limited on influence of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in a large adult population, including individuals with normal spirometry at baseline.

METHODS: Using the UK Biobank cohort, a multivariable Cox regression analysis was conducted on 406,424 individuals to examine the association between FEV1 and FVC, categorized into three groups based on their percentage of predicted values (%pred) (≥80, 60-80 and < 60), and overall mortality, cardiovascular mortality, myocardial infarction, stroke, and heart failure over approximately 12.5 years. Moreover, a subgroup analysis was conducted on 295,459 individuals who had normal spirometry.

RESULTS: Reduced FEV1 and FVC %pred values were associated with an elevated risk across all studied outcomes. Individuals with the lowest FEV1 and FVC %pred values (<60 %) exhibited HR of 1.83 (95 % CI 1.74-1.93) and 1.98 (95 % CI 1.76-2.22) for overall mortality, and 1.96 (95 % CI 1.83-2.1) and 2.26 (95 % CI 1.94-2.63) for cardiovascular mortality. Moreover, a graded association was observed between lower FEV1 and FVC %pred, even among never smokers and individuals with normal spirometry at baseline.

DISCUSSION: Reduced FEV1 and FVC represent robust risk factors for cardiovascular disease and mortality. The fact that the increased risk was evident also at FEV1 and FVC levels exceeding 80 %pred challenges the contemporary classification of lung function categories and the notion that the entire FEV1- and FVC-range above 80 % of predicted represents a normal lung function.

Place, publisher, year, edition, pages
2024. Vol. 227, article id 107614
Keywords [en]
Cardiovascular disease, FEV(1), FVC, Mortality, Population attributable fraction
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:du-48448DOI: 10.1016/j.rmed.2024.107614ISI: 001236790600001PubMedID: 38670319Scopus ID: 2-s2.0-85191312635OAI: oai:DiVA.org:du-48448DiVA, id: diva2:1855654
Available from: 2024-05-02 Created: 2024-05-02 Last updated: 2024-06-20Bibliographically approved

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Ärnlöv, Johan

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