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Zhou C, Ye Z, Zhang Y, He P, Liu M, Zhang Y, Yang S, Gan X, Nie J, Qin X. Association between lung function and risk of microvascular diseases in patients with diabetes: A prospective cohort and Mendelian randomization study. Nutr Metab Cardiovasc Dis 2024; 34:2378-2385. [PMID: 38862354 DOI: 10.1016/j.numecd.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND AND AIMS To investigate causal relationships of lung function with risks microvascular diseases among participants with diabetes, type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM), respectively, in prospective and Mendelian randomization (MR) study. METHODS AND RESULTS 14,617 participants with diabetes and without microvascular diseases at baseline from the UK Biobank were included in the prospective analysis. Of these, 13,421 had T2DM and 1196 had T1DM. The linear MR analyses were conducted in the UK Biobank with 6838 cases of microvascular diseases and 10,755 controls. Lung function measurements included forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). The study outcome was microvascular diseases, a composite outcome including chronic kidney diseases, retinopathy and peripheral neuropathy. During a median follow-up of 12.1 years, 2668 new-onset microvascular diseases were recorded. FVC (%predicted) was inversely associated with the risk of new-onset microvascular diseases in participants with diabetes (Per SD increment, adjusted HR = 0.86; 95%CI:0.83-0.89), T2DM (Per SD increment, adjusted HR = 0.86; 95%CI:0.82-0.90) and T1DM (Per SD increment, adjusted HR = 0.87; 95%CI: 0.79-0.97), respectively. Similar results were found for FEV1 (%predicted). In MR analyses, genetically predicted FVC (adjusted RR = 0.55, 95%CI:0.39-0.77) and FEV1 (adjusted RR = 0.48, 95%CI:0.28-0.83) were both inversely associated with microvascular diseases in participants with T1DM. No significant association was found in those with T2DM. Similar findings were found for each component of microvascular diseases. CONCLUSION There was a causal inverse association between lung function and risks of microvascular diseases in participants with T1DM, but not in those with T2DM.
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Affiliation(s)
- Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Jing Nie
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
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Zhou C, Zhang Y, Ye Z, Zhang Y, He P, Liu M, Yang S, Gan X, Xiang H, Huang Y, Qin X. Inverse association between lung function and nonalcoholic fatty liver disease: An observational and mendelian randomization study. Nutr Metab Cardiovasc Dis 2024:S0939-4753(24)00269-2. [PMID: 39168802 DOI: 10.1016/j.numecd.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 07/04/2024] [Accepted: 07/10/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND AND AIM The association between lung function with non-alcoholic fatty liver disease (NAFLD) in the general population remains unknown. We aimed to examine the association between lung function and NAFLD among the general population in an observational and Mendelian randomization (MR) study. METHODS AND RESULTS 340, 253 participants without prior liver diseases were included from the UK Biobank. Of these, 30,397 participants had liver proton density fat fraction (PDFF) measurements by magnetic resonance image (MRI). Lung function parameters included forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). The primary outcome was the presence of NAFLD, defined as a PDFF greater than 5.5%. The secondary outcome included incident severe NAFLD and severe liver diseases (including liver cirrhosis, liver failure, hepatocellular carcinoma and liver-related death), defined by the International Classification of Disease codes with different data sources. During a media follow-up duration of 9.3 years, 7335 (24.1%) the presence of NAFLD cases were documented. There was an inverse association of FEV1 (% predicted) (Per SD increment, adjusted OR = 0.91, 95%CI: 0.88-0.94) and FVC (% predicted) (Per SD increment, adjusted OR = 0.90, 95%CI: 0.87-0.92) with the presence of NAFLD. Similar results were found for incident severe NAFLD, severe liver disease, liver cirrhosis, liver failure and liver-related death. MR analyses showed that the genetically predicted FEV1 (adjusted OR = 0.63, 95%CI: 0.46-0.87) and FVC (adjusted OR = 0.69, 95%CI: 0.51-0.95) were both inversely associated with the presence of NAFLD. CONCLUSIONS There was an inverse causal relationship between lung function and NAFLD in the general population.
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Affiliation(s)
- Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Hao Xiang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yu Huang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
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Rydell A, Janson C, Lisspers K, Lin YT, Ärnlöv J. FEV 1 and FVC as robust risk factors for cardiovascular disease and mortality: Insights from a large population study. Respir Med 2024; 227:107614. [PMID: 38670319 DOI: 10.1016/j.rmed.2024.107614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
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.
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Affiliation(s)
- Andreas Rydell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden; Centrum För Klinisk Forskning, Region Dalarna, Falun, Sweden.
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research Uppsala University, Uppsala, Sweden
| | - Karin Lisspers
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
| | - Yi-Ting Lin
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden
| | - Johan Ärnlöv
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden; Centrum För Klinisk Forskning, Region Dalarna, Falun, Sweden; School of Health and Welfare, Dalarna University, Falun, Sweden
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Yang X, Liao J, Zhu S, Zhang C, Ma X, Zhang C, Wang Y, Sun K, Wang G. Association of high-sensitivity CRP and FEV1%pred: a study on non-pulmonary disease in a population in Beijing, China. BMJ Open Respir Res 2024; 11:e001699. [PMID: 38479820 PMCID: PMC10941139 DOI: 10.1136/bmjresp-2023-001699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 02/09/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND No studies have investigated whether high-sensitivity C reactive protein (hsCRP) can be used to predict the forced expiratory volume in 1 s (FEV1)/estimated value of FEV1 (FEV1%pred). This study aimed to assess the association between hsCRP and FEV1%pred in middle-aged and elderly individuals without underlying lung disease. METHODS The data for this study were obtained from a prospective cohort study that included 1047 middle-aged and elderly citizens from Beijing aged 40-75 years without any evidence of underlying lung diseases with FEV1 >70% after receiving inhalational bronchodilators. The baseline analysis of the participants was performed from 30 May 2018 to 31 October 2018. Restricted cubic spline regression and multivariate linear regression models were used to assess the non-linear association and linear association between hsCRP and FEV1/FEV in 6 s (FEV6) and FEV1%pred, respectively. RESULTS The hsCRP values of 851 participants were recorded; the values were normal in 713 (83.8%) participants. The remaining 196 participants (18.7%) had missing data. A non-linear association was observed between normal hsCRP values and FEV1/FEV6. hsCRP was linearly and negatively correlated with FEV1%pred, and each 1 SD increase in hsCRP was significantly associated with a 2.4% lower in FEV1%pred. Significantly higher FEV1/FEV6 differences were observed in the female subgroup than those in the male subgroup (p=0.011 for interaction). CONCLUSIONS hsCRP had a non-linear association with FEV1/FEV6 and a linear negative association with FEV1%pred in individuals with normal hsCRP values. hsCRP can be used to predict FEV1%pred, which can be used to predict the development of chronic obstructive pulmonary disease. hsCRP has a stronger association with lung function in women than that in men. TRIAL REGISTRATION NUMBER NCT03532893.
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Affiliation(s)
- Xiaoyu Yang
- Peking University First Hospital, Beijing, China
| | - Jiping Liao
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Sainan Zhu
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Cheng Zhang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xiaoyu Ma
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Chunbo Zhang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yunxia Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Kunyan Sun
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Guangfa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
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Hüzmeli İ, Katayıfçı N, Yalçın F, Hüzmeli ED. Effects of Different Inspiratory Muscle Training Protocols on Exercise Capacity, Respiratory Muscle Strength, and Health-Related Quality of Life in Patients with Hypertension. Int J Clin Pract 2024; 2024:4136457. [PMID: 38344141 PMCID: PMC10858798 DOI: 10.1155/2024/4136457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/03/2024] [Accepted: 01/18/2024] [Indexed: 02/15/2024] Open
Abstract
Aim This study aimed to explore how varying inspiratory muscle training workloads affect exercise capacity, health-related quality of life (HrQoL), depression, peripheral and respiratory muscle strength, pulmonary function, dyspnea, fatigue, and physical activity levels in hypertension (HT) patients. Methods A randomized, controlled three-arm study. Forty-five patients (58.37 ± 8.53 y, 7F/38M) with HT received IMT (7 days/8 weeks) by POWERbreathe® Classic LR device and were randomized to control group (CG, 10% maximal inspiratory pressure (MIP), n: 15), low-load group (LLG, 30% MIP), and high-load group (HLG, %50 MIP). Exercise capacity, HrQoL, depression, peripheral and respiratory muscle strength, pulmonary function, fatigue, physical activity level, dyspnea, and sleep quality were evaluated before and after the training. Results Exercise capacity, physical functioning, peripheral muscle strength, and resting dyspnea were statistically significantly improved in HLG and LLG after the training compared to CG (p < 0.05). Similar improvements in perception of depression, fatigue, and sleep quality were seen within and between the groups (p > 0.05). Statistically significant differences were found within all the groups in terms of MIP and PEF values of respiratory functions (p < 0.05). The superior improvement in the physical activity level was found in the HLG (p < 0.05). Discussion. High-load IMT was particularly effective in increasing physical activity level, peripheral muscle strength, exercise capacity, and improved HrQoL. Low-load IMT was effective in reducing dyspnea and improving respiratory function. Device-guided breathing exercises decreased blood pressure, improved sleep quality, and strengthened respiratory muscles. IMT, an efficient method, is suggested for inclusion in rehabilitation programs due to its capacity to increase physical activity, exercise capacity, and peripheral muscle strength, enhance HrQoL and respiratory function, and alleviate dyspnea. Also, the efficacy of IMT should be investigated with different training protocols such as endurance IMT or functional IMT in HT patients.
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Affiliation(s)
- İrem Hüzmeli
- Hatay Mustafa Kemal University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hatay, Türkiye
| | - Nihan Katayıfçı
- Hatay Mustafa Kemal University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hatay, Türkiye
| | - Fatih Yalçın
- Hatay Mustafa Kemal University, Faculty of Medicine, Department of Cardiology, Hatay, Türkiye
| | - Esra Doğru Hüzmeli
- Hatay Mustafa Kemal University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hatay, Türkiye
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Ukkat J, Rebelo A, Trojanowicz B. Angiogenetic transcriptional profiling reveals potential targets modulated in blood of patients with cardiovascular disorders. Vascular 2023; 31:152-162. [PMID: 34816786 DOI: 10.1177/17085381211052379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Based on the angiogenetic, transcriptional profile of non-diseased and arteriosclerotic vessels, we aim to identify the leucocytic markers as a potential, minimal invasive tool supporting diagnosis of vascular pathology. METHODS Transcriptional profiling was performed with Angiogenesis RT2 Profiler PCR (Polymerase Chain Reaction) array on three non-pathological and three arteriosclerotic vessels, followed by immunohistochemical staining. Based on these screening results, selected transcripts were employed for qPCR with specific primers and investigated on the blood RNA (RiboNucleic Acid) obtained from nine healthy controls and 29 patients with cardiovascular disorders. Thereafter, expression of these transcripts was investigated in vitro in human monocytes under calcification-mimicking conditions. RESULTS AND CONCLUSIONS Transcriptional profiling on the vessels revealed that out of 84 targets investigated two were up-regulated more than 100-fold, 18 more than 30 and 15 more than 10, while the most noticeable down-regulation was observed by ephrin-A3 and platelet-derived growth factor alpha (PDGFA) genes. Based on the vessel results, investigations of the selected blood transcripts revealed that thrombospondin 1 (THBS1), thrombospondin 3 (THBS3), transforming growth factor, beta receptor 1 (TGFBR1), platelet-derived growth factor alpha, plasminogen activator, urokinase (PLAU) and platelet/endothelial cell adhesion molecule 1 (PECAM-1) were significantly elevated in cardiovascular blood as compared to corresponding controls. Induction of calcification-related conditions in vitro to human THP-1 monocytes led to noticeable modulation of these transcripts. Taken together, these data demonstrate that leucocytic THBS1, THBS3, TGFBR1, platelet-derived growth factor alpha, PLAU and PECAM-1 have a correlation with cardiovascular disorders and could be used as a supportive tool predicting development of this pathological condition.
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Affiliation(s)
- Joerg Ukkat
- Department of Visceral, Vascular and Endocrine Surgery, 9176Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Artur Rebelo
- Department of Visceral, Vascular and Endocrine Surgery, 9176Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Bogusz Trojanowicz
- Department of Visceral, Vascular and Endocrine Surgery, 9176Martin Luther University Halle-Wittenberg, Halle, Germany
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LIU JL, WANG JQ, WANG D, QIN Y, ZHANG YQ, XIANG QY. The interaction effect of grip strength and lung function (especially FVC) on cardiovascular diseases: a prospective cohort study in Jiangsu Province, China. J Geriatr Cardiol 2022; 19:651-659. [PMID: 36284679 PMCID: PMC9548053 DOI: 10.11909/j.issn.1671-5411.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE Lung function and grip strength (GS) are associated with cardiovascular disease (CVD), but whether these risk factors interact to affect CVD is unknown. This study aimed to explore the interactions between lung function and GS with major CVD (defined as fatal/non-fatal myocardial infarction, stroke, and heart failure) incidence. METHODS We conducted a prospective cohort study on the Chinese population in Jiangsu Province. Cox proportional hazards models were used to explore the associations between GS, lung function, and major CVD incidence. RESULTS A total of 5967 participants were included in our study; among them, 182 participants developed major CVD. Participants with low forced vital capacity (FVC) had a higher risk of major CVD (hazard ratio (HR) = 1.45; 95% confidence interval (CI): 1.05-2.01; P < 0.05) compared with normal FVC. The risk of major CVD incidence (HR = 0.54; 95% CI: 0.35-0.83; P < 0.01) was significantly lower in participants with high GS than in individuals with low GS. The interaction between FVC and GS for major CVD incidence (P = 0.006) was statistically significant. Compared with normal FVC participants with high GS, low FVC participants with low GS had the highest risk of major CVD incidence (HR = 2.50; 95% CI: 1.43-4.36; P < 0.01). CONCLUSION Among people with low FVC, the risk of major CVD is lower with high GS. Participants with low FVC and low GS have the highest risk of major CVD. Therefore, more attention should be paid to the incidence of major CVD in individuals with low FVC, especially those who have lower GS.
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Affiliation(s)
- Jia-Li LIU
- School of Public Health, Southeast University; Nanjing, Jiangsu Province, China
| | - Jia-Qi WANG
- School of Public Health, Southeast University; Nanjing, Jiangsu Province, China
| | - Dan WANG
- School of Public Health, Southeast University; Nanjing, Jiangsu Province, China
| | - Yu QIN
- Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention; Nanjing, Jiangsu Province, China
| | - Yong-Qing ZHANG
- Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention; Nanjing, Jiangsu Province, China
| | - Quan-Yong XIANG
- School of Public Health, Southeast University; Nanjing, Jiangsu Province, China
- Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention; Nanjing, Jiangsu Province, China
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McNeill JN, Lee DH, Hwang SJ, Courchesne P, Yao C, Huan T, Joehanes R, O’Connor GT, Ho JE, Levy D. Association of 71 cardiovascular disease-related plasma proteins with pulmonary function in the community. PLoS One 2022; 17:e0266523. [PMID: 35390066 PMCID: PMC8989231 DOI: 10.1371/journal.pone.0266523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 03/22/2022] [Indexed: 11/19/2022] Open
Abstract
RATIONALE It has been speculated that shared mechanisms underlie respiratory and cardiovascular diseases (CVD) including systemic inflammation or mutual risk factors. In this context, we sought to examine the associations of CVD-related plasma proteins with lung function as measured by spirometry in a large community-based cohort of adults. METHODS The study included 5777 Framingham Heart Study participants who had spirometry and measurement of 71 CVD-related plasma proteins. The association of plasma proteins with lung function was assessed cross-sectionally and longitudinally using models accounting for familial correlations. Linear mixed models were used for the following measurements: FEV1%predicted, FVC%predicted, and FEV1/FVC ratio with secondary analyses examining obstructive and restrictive physiology at baseline and their new onset during follow up. MEASUREMENTS AND MAIN RESULTS Among the 71 CVD-related plasma proteins, 13 proteins were associated in cross-sectional analyses with FEV1%predicted, 17 proteins were associated with FVC%predicted, and 1 protein was associated with FEV1/FVC. The proteins with the greatest inverse relations to FEV1%predicted and FVC%predicted included leptin, adrenomedullin, and plasminogen activator inhibitor-1; in contrast there were three proteins with positive relations to FEV1%predicted and FVC%predicted including insulin growth factor binding protein 2, tetranectin, and soluble receptor for advanced glycation end products. In longitudinal analyses, three proteins were associated with longitudinal change in FEV1 (ΔFEV1) and four with ΔFVC; no proteins were associated with ΔFEV1/FVC. CONCLUSION Our findings highlight CVD-related plasma proteins that are associated with lung function including markers of inflammation, adiposity, and fibrosis, representing proteins that may contribute both to respiratory and CVD risk.
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Affiliation(s)
- Jenna N. McNeill
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Dong Heon Lee
- The Framingham Heart Study, Framingham, Massachusetts, and the Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Shih-Jen Hwang
- The Framingham Heart Study, Framingham, Massachusetts, and the Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Paul Courchesne
- The Framingham Heart Study, Framingham, Massachusetts, and the Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Chen Yao
- The Framingham Heart Study, Framingham, Massachusetts, and the Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Tianxiao Huan
- The Framingham Heart Study, Framingham, Massachusetts, and the Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Roby Joehanes
- The Framingham Heart Study, Framingham, Massachusetts, and the Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - George T. O’Connor
- Pulmonary Center, Boston University, Boston, Massachusetts, United States of America
| | - Jennifer E. Ho
- Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Daniel Levy
- The Framingham Heart Study, Framingham, Massachusetts, and the Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
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Respiratory Symptom Screening in Prevention. Chest 2022; 161:876-877. [DOI: 10.1016/j.chest.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/20/2022] Open
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10
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Kulbacka-Ortiz K, Triest FJJ, Franssen FME, Wouters EFM, Studnicka M, Vollmer WM, Lamprecht B, Burney PGJ, Amaral AFS, Vanfleteren LEGW. Restricted spirometry and cardiometabolic comorbidities: results from the international population based BOLD study. Respir Res 2022; 23:34. [PMID: 35177082 PMCID: PMC8855577 DOI: 10.1186/s12931-022-01939-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background Whether restricted spirometry, i.e. low Forced Vital Capacity (FVC), predicts chronic cardiometabolic disease is not definitely known. In this international population-based study, we assessed the relationship between restricted spirometry and cardiometabolic comorbidities. Methods A total of 23,623 subjects (47.5% males, 19.0% current smokers, age: 55.1 ± 10.8 years) from five continents (33 sites in 29 countries) participating in the Burden of Obstructive Lung Disease (BOLD) study were included. Restricted spirometry was defined as post-bronchodilator FVC < 5th percentile of reference values. Self-reports of physician-diagnosed cardiovascular disease (CVD; heart disease or stroke), hypertension, and diabetes were obtained through questionnaires. Results Overall 31.7% of participants had restricted spirometry. However, prevalence of restricted spirometry varied approximately ten-fold, and was lowest (8.5%) in Vancouver (Canada) and highest in Sri Lanka (81.3%). Crude odds ratios for the association with restricted spirometry were 1.60 (95% CI 1.37–1.86) for CVD, 1.53 (95% CI 1.40–1.66) for hypertension, and 1.98 (95% CI 1.71–2.29) for diabetes. After adjustment for age, sex, education, Body Mass Index (BMI) and smoking, the odds ratios were 1.54 (95% CI 1.33–1.79) for CVD, 1.50 (95% CI 1.39–1.63) for hypertension, and 1.86 (95% CI 1.59–2.17) for diabetes. Conclusion In this population-based, international, multi-site study, restricted spirometry associates with cardiometabolic diseases. The magnitude of these associations appears unattenuated when cardiometabolic risk factors are taken into account.
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Affiliation(s)
- Katarzyna Kulbacka-Ortiz
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Filip J J Triest
- CIRO, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Department of Respiratory Medicine, AZ Sint-Lucas, Gent, Belgium.,Department of Respiratory Medicine, MUMC+, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Frits M E Franssen
- CIRO, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Department of Respiratory Medicine, MUMC+, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Emiel F M Wouters
- CIRO, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Department of Respiratory Medicine, MUMC+, Maastricht University Medical Centre, Maastricht, the Netherlands.,Ludwig Boltzman Institute for Lung Health, Vienna, Austria
| | - Michael Studnicka
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
| | | | - Bernd Lamprecht
- Department of Pulmonary Medicine, Kepler-University-Hospital, Linz, Austria.,Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
| | - Peter G J Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andre F S Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Lowie E G W Vanfleteren
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden. .,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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11
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AGBAJE ANDREWO, BARKER ALANR, TUOMAINEN TOMIPEKKA. Cardiorespiratory Fitness, Fat Mass, and Cardiometabolic Health with Endothelial Function, Arterial Elasticity, and Stiffness. Med Sci Sports Exerc 2022; 54:141-152. [PMID: 34334718 PMCID: PMC8677603 DOI: 10.1249/mss.0000000000002757] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine whether estimated cardiorespiratory fitness (CRF), fat mass (FM), lean mass (LM), and adiponectin bidirectionally associate with arterial function and structure and if CRF mediates the relationship between cardiometabolic health and arterial outcomes in 9- to 11-yr-old children drawn from the Avon Longitudinal Study of Parents and Children birth cohort, United Kingdom. METHODS Brachial artery flow-mediated dilation (FMD), distensibility coefficient (DC), and carotid-radial pulse wave velocity (PWV) were measured by ultrasonography; CRF was measured during the submaximal ergometer test; total FM, trunk FM, and LM were measured by dual-energy x-ray absorptiometry; plasma adiponectin was measured by enzyme assay; and cardiometabolic health was computed based on the International Diabetes Federation criteria for diagnosing metabolic syndrome. We tested bidirectionality by including CRF, FM, LM, and adiponectin as exposures and FMD, DC, and PWV as outcomes, alternatively. RESULTS Among 5566 participants (2816 (51%) girls; median age, 9.75 yr), CRF per body mass0.21 was directly related to DC (β (95% confidence interval) = 0.004 (<0.0001 to 0.008); P = 0.046), whereas CRF per LM0.54 was inversely associated with PWV (-0.034 (-0.063 to -0.003); 0.032) after adjusting for covariates. These associations remained in bidirectional analyses. Total FM, trunk FM, and LM were bidirectionally and positively associated with FMD and DC. Total FM and trunk FM but not LM had bidirectional and inverse associations with PWV. Adiponectin was not related to FMD, DC, or PWV. CRF partially mediated the associations of cardiometabolic health with FMD (1.5% mediation), DC (12.1% mediation), and PWV (3.5% mediation). CONCLUSIONS Associations of poor cardiometabolic health with adverse arterial structure and function in childhood may be mitigated by increasing CRF. Higher CRF was associated with better arterial structure whereas higher total FM and trunk FM were associated with better arterial function and structure. In the reverse analysis, healthy arterial structure and function were independently associated with increased total FM and trunk FM, suggesting an "arterial paradox."
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Affiliation(s)
- ANDREW O. AGBAJE
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
| | - ALAN R. BARKER
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - TOMI-PEKKA TUOMAINEN
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
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12
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Wang J, Dai H, Chen C, Ding G, Zhang Y, Qin Y, Zhang Y, Xiang Q. Relationship between lung function impairment, hypertension, and major adverse cardiovascular events: A 10-year follow-up study. J Clin Hypertens (Greenwich) 2021; 23:1930-1938. [PMID: 34530489 PMCID: PMC8678850 DOI: 10.1111/jch.14364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/21/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Abstract
Lung function impairment and hypertension, especially hypertension, are risk factors of major adverse cardiovascular events (MACEs). However, the relationships among lung function impairment, hypertension, and MACEs have not been well‐reported. We aimed to investigate the association between lung function and hypertension and MACEs. We studied 6769 people who were a representative sample of the general population in Jiangsu Province using the multi‐stage stratified cluster sampling method. The average age was 51.54 years. Cox proportional hazards models were used to analyze the relationships between the blood pressure status and various types of lung function impairment related to MACEs. Over a follow‐up of 10 years, 236 MACEs occurred. After adjusting for age, sex, BMI, smoking, drinking, education, physical activity, diabetes mellitus, dyslipidemia, creatine and use of antihypertensive drugs, hypertension [hazard ratio (HR) = 2.154, 95% confidence intervals (CI): 1.565–2.966], and restrictive lung function impairment (RLFI) (HR = 1.398, 95% CI: 1.021–1.879) were independently associated with MACEs. Individuals with hypertension and RFLI had the highest risk for MACEs (HR = 2.930, 95% CI: 1.734–4.953) and stroke (HR = 3.296, 95% CI: 1.862–5.832). Moreover, when combined with hypertension, obstructive lung function impairment (OLFI) (HR = 2.376, 95% CI: 1.391–4.056) and mixed lung function impairment (MLFI) (HR = 2.423, 95% CI: 1.203–4.882) were associated with MACEs. There is a synergistic effect of lung function impairment (especially RLFI) and hypertension on MACEs. Therefore, more attention should be paid to the incidence of MACEs in individuals with impaired lung function, especially those who have hypertension.
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Affiliation(s)
- Jiaqi Wang
- School of Public Health, Southeast University, Nanjing, Jiangsu Province, China
| | - He Dai
- Department of Cardiology, Nanjing Jiangning Hospital, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Chong Chen
- School of Public Health, Southeast University, Nanjing, Jiangsu Province, China
| | - Ganling Ding
- School of Public Health, Southeast University, Nanjing, Jiangsu Province, China
| | - Yongqing Zhang
- Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu Province, China
| | - Yu Qin
- Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu Province, China
| | - Yuqing Zhang
- Department of Cardiology, Nanjing Jiangning Hospital, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Quanyong Xiang
- School of Public Health, Southeast University, Nanjing, Jiangsu Province, China.,Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu Province, China
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13
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Ma H, Liu F, Yang X, Liu Q, Wang X, Xing X, Lin Z, Cao J, Li J, Huang K, Yan W, Liu T, Fan M, Chen S, Lu X, Gu D, Huang J. Association of short-term fine particulate matter exposure with pulmonary function in populations at intermediate to high-risk of cardiovascular disease: A panel study in three Chinese cities. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 220:112397. [PMID: 34116334 DOI: 10.1016/j.ecoenv.2021.112397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/24/2021] [Accepted: 05/30/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Decline in pulmonary function contributes to increasing cardiovascular disease (CVD) risk. Although adverse effects of short-term exposure to fine particulate matter (PM2.5) on pulmonary function have been recognized in healthy people or patients with respiratory disease, these results were not well illustrated among people with elevated CVD risk. MATERIALS AND METHODS A panel study was conducted in three Chinese cities with three repeated visits among populations at intermediate to high-risk of CVD, defined as treated hypertension patients or those with blood pressure ≥ 130/80 mmHg, who met any of the three conditions including abdominal obesity, dyslipidemia, and diabetes mellitus. Individualized PM2.5 exposure and pulmonary function were measured during each seasonal visit. Linear mixed-effect models were applied to analyze the associations of PM2.5 concentrations with pulmonary function indicators, including forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity (FVC), maximal mid-expiratory flow (MMF), and peak expiratory flow (PEF). RESULTS Short-term PM2.5 exposure was significantly associated with decreased pulmonary function and an increment of 10 μg/m3 in PM2.5 concentrations during lag 12-24 hour was associated with declines of 41.7 ml/s (95% confidence interval [CI]: 7.7-75.7), 0.35% (95% CI: 0.01, 0.69), and 20.9 ml/s (95% CI: 0.5-41.3) for PEF, FEV1/FVC, and MMF, respectively. Results from stratified and sensitivity analyses were generally similar with the overall findings, while the adverse effects of PM2.5 on pulmonary functions were more pronounced in those who were physically inactive. CONCLUSIONS This study first identified short-term exposure to PM2.5 was associated with impaired pulmonary function and physical activity might attenuate the adverse effects of PM2.5 among populations at intermediate to high-risk of CVD. These findings provide new robust evidence on health effects of air pollution and call for effective prevention measures among people at CVD risk.
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Affiliation(s)
- Han Ma
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Qiong Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Xinyan Wang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Center for Reproductive Medicine, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin 300100, China
| | - Xiaolong Xing
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Zhennan Lin
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Keyong Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Weili Yan
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201100, China
| | - Tingting Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Meng Fan
- State Key Laboratory of Remote Sensing Science, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100101, China
| | - Shufeng Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China.
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14
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Zekavat SM, Honigberg M, Pirruccello JP, Kohli P, Karlson EW, Newton-Cheh C, Zhao H, Natarajan P. Elevated Blood Pressure Increases Pneumonia Risk: Epidemiological Association and Mendelian Randomization in the UK Biobank. MED 2021; 2:137-148.e4. [PMID: 33283203 PMCID: PMC7703520 DOI: 10.1016/j.medj.2020.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/22/2020] [Accepted: 11/02/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Small studies have correlated hypertension with pneumonia risk; whether this is recapitulated in larger prospective studies, and represents a causal association, is unclear. METHODS We estimated the risk for prevalent hypertension with incident respiratory diseases over mean follow-up of 8 years among 377,143 British participants in the UK Biobank. Mendelian randomization of blood pressure on pneumonia was implemented using 75 independent, genome-wide significant variants associated with systolic and diastolic blood pressures among 299,024 individuals not in the UK Biobank. Secondary analyses with pulmonary function tests were performed. FINDINGS In total, 107,310 participants (30%) had hypertension at UK Biobank enrollment, and 9,969 (3%) developed pneumonia during follow-up. Prevalent hypertension was independently associated with increased risk for incident pneumonia (HR: 1.36; 95% CI: 1.29-1.43; p < 0.001), as well as other incident respiratory diseases. Genetic predisposition to a 5 mm Hg increase in blood pressure was associated with increased risk for incident pneumonia for systolic blood pressure (HR: 1.08; 95% CI: 1.04-1.13; p < 0.001) and diastolic blood pressure (HR: 1.11; 95% CI: 1.03-1.20; p = 0.005). Additionally, consistent with epidemiologic associations, increased blood pressure genetic risk was significantly associated with reduced performance on pulmonary function tests (p < 0.001). CONCLUSIONS These results suggest that elevated blood pressure increases risk for pneumonia. Maintaining adequate blood pressure control, in addition to other measures, may reduce risk for pneumonia. FUNDING S.M.Z. (1F30HL149180-01), M.H. (T32HL094301-07), and P.N. (R01HL1427, R01HL148565, and R01HL148050) are supported by the National Institutes of Health. J.P. is supported by the John S. LaDue Memorial Fellowship.
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Affiliation(s)
- Seyedeh M Zekavat
- Yale School of Medicine, New Haven, CT, USA
- Computational Biology & Bioinformatics Program, Yale University, New Haven, CT, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Michael Honigberg
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - James P Pirruccello
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Puja Kohli
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Vertex Pharmaceuticals, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth W Karlson
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Allergy, Immunology, and Rheumatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher Newton-Cheh
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Hongyu Zhao
- Computational Biology & Bioinformatics Program, Yale University, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Pradeep Natarajan
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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15
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Sugiura T, Dohi Y, Takagi Y, Yokochi T, Yoshikane N, Suzuki K, Tomiishi T, Nagami T, Iwase M, Takase H, Seo Y, Ohte N. Close Association between Subclinical Atherosclerosis and Pulmonary Function in Middle-Aged Male Smokers. J Atheroscler Thromb 2020; 27:1230-1242. [PMID: 32536635 PMCID: PMC7803833 DOI: 10.5551/jat.55996] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
AIMS Cigarette smoking provokes deleterious influences on cardiovascular and pulmonary systems, although the underlying relationship has not been sufficiently investigated especially in early-stage disease. The present study investigated possible associations between subclinical atherosclerosis and pulmonary function in middle-aged male smokers. METHODS Male smokers undergoing their periodic health check-up were enrolled in this study (n=3,775, 45±8 years). Pulmonary function was evaluated using spirometry by calculating forced vital capacity (FVC) as a percentage of predicted value (FVC%-predicted), forced expiratory volume in one second (FEV1) as a percentage of predicted value (FEV1%-predicted), and the ratio of FEV1 to FVC (FEV1/FVC). Subclinical atherosclerosis was assessed based on ankle-brachial pressure index (ABI), cardio-ankle vascular index (CAVI), ultrasound examination of the carotid intima-media thickness (IMT), and presence of plaque. RESULTS Multivariate regression analysis showed that ABI was positively associated with FVC%-predicted and FEV1%-predicted after adjustment for confounders including smoking intensity, while CAVI or carotid IMT was inversely associated with both. Participants with chronic obstructive pulmonary disease (COPD, n=256) showed reduced ABI and increased CAVI or carotid IMT compared with those without COPD, and participants with carotid plaque had lower pulmonary function than those without plaque. Reduced FEV1/FVC was an independent determinant of carotid plaque and decreased ABI was an independent determinant of COPD, as revealed by logistic regression analysis with the endpoint of carotid plaque presence or a diagnosis of COPD revealed. CONCLUSIONS Middle-aged male smokers showed a close association between subclinical atherosclerosis and pulmonary function, implying that smoking induced-vascular and pulmonary damage are interacting in early-stage disease.
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Affiliation(s)
- Tomonori Sugiura
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences.,Health Support Center WELPO, Toyota Motor Corporation
| | - Yasuaki Dohi
- Health Support Center WELPO, Toyota Motor Corporation.,Department of Internal Medicine, Faculty of Rehabilitation Sciences, Nagoya Gakuin University
| | - Yasuyuki Takagi
- Health Support Center WELPO, Toyota Motor Corporation.,Toyota Memorial Hospital
| | - Takashi Yokochi
- Health Support Center WELPO, Toyota Motor Corporation.,Midtown Clinic Meieki
| | | | - Kenji Suzuki
- Health Support Center WELPO, Toyota Motor Corporation
| | | | | | | | - Hiroyuki Takase
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences.,Department of Internal Medicine, Enshu Hospital
| | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | - Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
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16
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Ramalho SHR, Shah AM. Lung function and cardiovascular disease: A link. Trends Cardiovasc Med 2020; 31:93-98. [PMID: 31932098 DOI: 10.1016/j.tcm.2019.12.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 11/27/2019] [Accepted: 12/25/2019] [Indexed: 02/08/2023]
Abstract
The relationship between lung and heart diseases has long been recognized, with necropsy studies demonstrating silent myocardial infarctions or coronary artery calcification in patients with advanced emphysema as the death cause. Improvements in non-invasive techniques and epidemiologic approaches established that lung and cardiovascular diseases frequently coexist in mid and late life. Even among those without diagnosed lung disease, lower than expected forced vital capacity, forced expiratory volume in 1 s, and their ratio each portend greater risk of developing cardiovascular risk factors including hypertension, obesity, and metabolic syndrome, and for incident cardiovascular diseases including left heart failure, atrial fibrillation and stroke. Greater longitudinal declines in these spirometric measures are further associated with cardiovascular morbidity and mortality. While obstructive ventilatory patterns are more common, restrictive ventilatory patterns seem to demonstrate an independent and more robust association with cardiovascular diseases such as heart failure. These subclinical alterations in pulmonary function also relate to subclinical abnormalities of cardiac structure and function. Although the biologic pathways linking pulmonary and cardiovascular dysfunction are not clear, chronic systemic inflammation appears to be one important underlying pathophysiologic link. Despite the growing evidence of lung dysfunction as a cardiovascular risk factor, spirometric evaluation is still underutilized in clinical practice, particularly among cardiac patients, and optimal therapeutic and preventive strategies are still unclear. In this review, we address the current knowledge and controversies regarding the links between lung function and cardiovascular disease.
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Affiliation(s)
- Sergio H R Ramalho
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02445, USA; Health Sciences and Technologies Program, University of Brasilia, Brazil
| | - Amil M Shah
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02445, USA.
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17
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Cuttica MJ, Colangelo LA, Dransfield MT, Bhatt SP, Rana JS, Jacobs DR, Thyagarajan B, Sidney S, Lewis CE, Liu K, Lloyd-Jones D, Washko G, Kalhan R. Lung Function in Young Adults and Risk of Cardiovascular Events Over 29 Years: The CARDIA Study. J Am Heart Assoc 2019; 7:e010672. [PMID: 30561252 PMCID: PMC6405620 DOI: 10.1161/jaha.118.010672] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Diminished peak lung function in young adulthood is a risk factor for future chronic obstructive pulmonary disease. The association between lung disease and cardiovascular disease later in life is well documented. Whether peak lung function measured in young adulthood is associated with risk of future cardiovascular events is unknown. Methods and Results CARDIA (The Coronary Artery Risk Development in Young Adults) study is a prospective, multicenter, community‐based, longitudinal cohort study including 4761 participants aged 18 to 30 years with lung function testing we investigated the association between lung health in young adulthood and risk of subsequent cardiovascular events. We performed Cox proportional hazards regression to test the association between baseline and years 10 and 20 pulmonary function with incident cardiovascular events. Linear and logistic regression was performed to explore the associations of lung function with development of risk factors for cardiovascular disease as well as carotid intima‐media thickness and coronary artery calcified plaque. At baseline, mean age (±SD) was 24.9±3.6 years. Baseline forced expiratory volume in 1 second (hazard ratio) per −10‐unit decrement in percent predicted forced expiratory volume in 1 second (hazard ratio, 1.18; 95% CI, 1.06–1.31 [P=0.002]) and FVC per −10‐unit decrement in percent predicted FVC (hazard ratio, 1.19; 95% CI, 1.06–1.33 [P=0.003]) were associated with future cardiovascular events independent of traditional cardiovascular risk factors. Baseline lung function was associated with heart failure and cerebrovascular events but not coronary artery disease events. Conclusions Lung function in young adulthood is independently associated with cardiovascular events into middle age. This association appears to be driven by heart failure and cerebrovascular events rather than coronary heart disease. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT00005130.
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Affiliation(s)
- Michael J Cuttica
- 1 Division of Pulmonary and Critical Care Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Laura A Colangelo
- 2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Mark T Dransfield
- 3 Division of Pulmonary, Allergy and Critical Care Medicine University of Alabama School of Medicine Birmingham AL
| | - Surya P Bhatt
- 3 Division of Pulmonary, Allergy and Critical Care Medicine University of Alabama School of Medicine Birmingham AL
| | - Jamal S Rana
- 4 Division of Cardiology Kaiser Permanente Northern California Oakland CA.,6 Division of Research Kaiser Permanente Northern California Oakland CA
| | - David R Jacobs
- 5 Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
| | - Bharat Thyagarajan
- 5 Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
| | - Stephen Sidney
- 6 Division of Research Kaiser Permanente Northern California Oakland CA
| | - Cora E Lewis
- 7 Division of Preventive Medicine Department of Medicine University of Alabama at Birmingham AL
| | - Kiang Liu
- 2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Donald Lloyd-Jones
- 2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - George Washko
- 8 Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital Boston MA
| | - Ravi Kalhan
- 1 Division of Pulmonary and Critical Care Medicine Feinberg School of Medicine Northwestern University Chicago IL.,2 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
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18
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Marron MM, Wojczynski MK, Minster RL, Boudreau RM, Sebastiani P, Cosentino S, Thyagarajan B, Ukraintseva SV, Schupf N, Christensen K, Feitosa M, Perls T, Zmuda JM, Newman AB. Heterogeneity of healthy aging: comparing long-lived families across five healthy aging phenotypes of blood pressure, memory, pulmonary function, grip strength, and metabolism. GeroScience 2019; 41:383-393. [PMID: 31332674 PMCID: PMC6815318 DOI: 10.1007/s11357-019-00086-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/08/2019] [Indexed: 02/04/2023] Open
Abstract
Five healthy aging phenotypes were developed in the Long Life Family Study to uncover longevity pathways and determine if healthy aging across multiple systems clustered in a subset of long-lived families. Using blood pressure, memory, pulmonary function, grip strength, and metabolic measures (body mass index, waist circumference and fasting levels of glucose, insulin, triglycerides, lipids, and inflammatory markers), offspring were ranked according to relative health using gender-, age-, and relevant confounder-adjusted z-scores. Based on our prior work, families met a healthy aging phenotype if ≥ 2 and ≥ 50% of their offspring were exceptionally healthy for that respective phenotype. Among 426 families, only two families met criteria for three healthy aging phenotypes and none met criteria for four or more healthy aging phenotypes. Using Spearman correlation, the proportion of offspring within families with exceptionally healthy pulmonary function was correlated with the proportion of offspring within families with exceptional strength (r = 0.19, p = 0.002). The proportion of offspring within families meeting the healthy blood pressure and metabolic phenotypes were also correlated (r = 0.14, p = 0.006), and more families were classified as meeting healthy blood pressure and metabolic phenotypes (Kappa = 0.10, p = 0.02), as well as the healthy pulmonary and blood pressure phenotypes than expected by chance (Kappa = 0.09, p = 0.03). Other phenotypes were weakly correlated (|r| ≤ 0.07) with low pairwise agreement (Kappa ≤ 0.06). Among these families selected for familial longevity, correspondence between healthy aging phenotypes was weak, supporting the heterogeneous nature of longevity and suggesting biological underpinnings of each individual phenotype should be examined separately to determine their shared and unique determinants.
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Affiliation(s)
- Megan M Marron
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 5126 Public Health, 130 DeSoto Street, Pittsburgh, PA, 15261, USA
| | - Mary K Wojczynski
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ryan L Minster
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 5126 Public Health, 130 DeSoto Street, Pittsburgh, PA, 15261, USA
| | - Paola Sebastiani
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | | | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Kaare Christensen
- The Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mary Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Thomas Perls
- Department of Medicine, Geriatrics Section, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Joseph M Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 5126 Public Health, 130 DeSoto Street, Pittsburgh, PA, 15261, USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 5126 Public Health, 130 DeSoto Street, Pittsburgh, PA, 15261, USA.
- Departments of Medicine and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, USA.
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Pulmonary Function Tests in Hypertensive Patients Attending Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Int J Hypertens 2018; 2018:5492680. [PMID: 30538860 PMCID: PMC6260409 DOI: 10.1155/2018/5492680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/02/2018] [Accepted: 10/23/2018] [Indexed: 11/17/2022] Open
Abstract
Background Hypertension imposes stresses on many organs like heart and kidney. However, studies that show the effect of hypertension on the lungs are limited. Objective To assess pulmonary function status of hypertensive patients aged 30-64 years at Zewditu Memorial Hospital, 2017. Methods Hospital based comparative cross-sectional study was conducted on 61 hypertensive patients (cases) and 61 nonhypertensive clients (controls) aged 30-64 years. Computerized spirometry was done in all cases and controls which were selected by systematic sampling technique. The study was conducted from January 20, 2017, to May 25, 2017. Result. The values of FVC, FEV1, and FEF25-75% were 3.52±1.02 liters, 2.97±0.89 liters, and 3.34±1.3 liters/second in hypertensive patients and 4.31±0.82 liters, 3.54±0.7 liters, and 3.94±1.09 liters/second in controls, respectively. These values were significantly lower (p<0.05) in hypertensive patients compared to controls. Restrictive pulmonary defect was dominant in hypertensive patients. FEV1% which was 85%±7% in hypertensive patients and 82%±5% in controls was significantly higher (p<0.05) in hypertensive patients compared to controls. Conclusion Hypertensive patients exhibit lower pulmonary function values. Routine check-up of the pulmonary function status of such patients should be done to prevent undesired outcomes.
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Miele CH, Grigsby MR, Siddharthan T, Gilman RH, Miranda JJ, Bernabe-Ortiz A, Wise RA, Checkley W. Environmental exposures and systemic hypertension are risk factors for decline in lung function. Thorax 2018; 73:1120-1127. [PMID: 30061168 PMCID: PMC7289445 DOI: 10.1136/thoraxjnl-2017-210477] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/01/2018] [Accepted: 06/18/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Chronic lung disease is a leading contributor to the global disease burden; however, beyond tobacco smoke, we do not fully understand what risk factors contribute to lung function decline in low-income and middle-income countries. METHODS We collected sociodemographic and clinical data in a randomly selected, age-stratified, sex-stratified and site-stratified population-based sample of 3048 adults aged ≥35 years from four resource-poor settings in Peru. We assessed baseline and annual pre-bronchodilator and post-bronchodilator lung function over 3 years. We used linear mixed-effects models to assess biological, socioeconomic and environmental risk factors associated with accelerated lung function decline. RESULTS Mean±SD enrolment age was 55.4±12.5 years, 49.2% were male and mean follow-up time was 2.36 (SD 0.61) years. Mean annual pre-bronchodilator FEV1 decline was 30.3 mL/year (95% CI 28.6 to 32.0) and pre-bronchodilator FVC decline was 32.2 mL/year (30.0 to 34.4). Using multivariable linear mixed-effects regression, we found that urban living, high-altitude dwelling and having hypertension accounted for 25.9% (95% CI 15.7% to 36.1%), 21.3% (11.1% to 31.5%) and 15.7% (3.7% to 26.9%) of the overall mean annual decline in pre-bronchodilator FEV1/height2, respectively. Corresponding estimates for pre-bronchodilator FVC/height2 were 42.1% (95% CI% 29.8% to 54.4%), 36.0% (23.7% to 48.2%) and 15.8% (2.6% to 28.9%) of the overall mean annual decline, respectively. CONCLUSION Urbanisation, living at high altitude and hypertension were associated with accelerated lung function decline in a population with low daily smoking prevalence.
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Affiliation(s)
- Catherine H Miele
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Matthew R Grigsby
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Trishul Siddharthan
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Robert H Gilman
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - J Jaime Miranda
- CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Departamento de Medicina, Escuela de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert A Wise
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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21
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Blaes AH, Mulrooney DA, Vogel RI, Solovey A, Hebbel R, Peterson BA, Neglia JP, Biewen C, Konety SH, Duprez DA. Arterial elasticity as a risk factor for early cardiovascular disease among testicular cancer survivors treated with platinum-based chemotherapy: a cross-sectional pilot study. Vasc Health Risk Manag 2018; 14:205-211. [PMID: 30237722 PMCID: PMC6136418 DOI: 10.2147/vhrm.s151847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Testicular cancer survivors who have received platinum-based chemotherapy are at risk for premature cardiovascular disease. The etiology of this risk is not well understood. This pilot study explores the impact of platinum-based chemotherapy on endothelial function. METHODS Testicular cancer survivors <30 years old at the time of diagnosis who received platinum-based chemotherapy between 2002 and 2012, as well as 17 similarly aged male controls, were identified. Consented subjects underwent vascular assessment using the HDI/PulseWave CR-2000 Cardiovascular Profiling System and the Endo-PAT2000 system. Biomarkers and functional test markers were compared among cases, controls, and a group of historical controls using two sided two-sampled t-tests and Wilcoxon rank-sum tests. RESULTS Thirteen survivors with a median age of 30.2 years and body mass index of 27.3 were enrolled, along with 17 healthy controls with a median age of 27.1 years and body mass index of 24.8. Median time from chemotherapy was 4.7 (range: 0.8-14) years. There was no statistical difference in reactive hyperemia peripheral arterial tonometry ratio between cases and controls (p = 0.574). There was no statistical difference in small or large artery elasticity between cases and controls (p = 0.086) or between cases and historical controls (p = 0.729). There was also no statistical difference in the blood levels of circulating endothelial cells, von Willebrand factor, and vascular cell adhesion molecules. There was a trend toward increased metabolic syndrome in cases (15%) as compared to recruited controls (6%), though this difference was not statistically significant (p = 0.565). CONCLUSION Testicular cancer survivors have no clinically significant difference in endothelial function compared to controls 4 years after the completion of chemotherapy. Further research is needed to explore the secondary modifiable causes that may contribute to the risk of premature cardiovascular disease.
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Affiliation(s)
- Anne H Blaes
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA,
| | | | | | - Anna Solovey
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA,
| | - Robert Hebbel
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA,
| | - Bruce A Peterson
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA,
| | | | - Carter Biewen
- Division of Pediatrics, University of California San Francisco, CA, USA
| | - Suma H Konety
- Division of Cardiology, University of Minnesota, MN, USA
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22
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Silvestre OM, Nadruz W, Querejeta Roca G, Claggett B, Solomon SD, Mirabelli MC, London SJ, Loehr LR, Shah AM. Declining Lung Function and Cardiovascular Risk: The ARIC Study. J Am Coll Cardiol 2018; 72:1109-1122. [PMID: 30165982 PMCID: PMC6121739 DOI: 10.1016/j.jacc.2018.06.049] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 06/18/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Pulmonary dysfunction predicts incident cardiovascular disease (CVD). OBJECTIVES The purpose of this study was to evaluate whether longitudinal decline in lung function is associated with incident heart failure (HF), coronary heart disease (CHD), and stroke. METHODS Among 10,351 participants in the ARIC (Atherosclerosis Risk In Communities) study free of CVD, rapid lung function decline was defined as the greatest quartile (n = 2,585) of decline in either forced expiratory volume in 1 s (FEV1) (>1.9% decline/year) or forced vital capacity (FVC) (>2.1% decline/year) over 2.9 ± 0.2 years. The relationship between rapid decline in FEV1 or FVC and subsequent incident HF, CHD, stroke, or a composite of these was assessed using multivariable Cox regression adjusting for the baseline spirometry value, demographics, height, body mass index, heart rate, diabetes, hypertension, low-density lipoprotein, use of lipid-lowering medication, N-terminal fragment of prohormone for B-type natriuretic peptide, and smoking. RESULTS The mean age was 54 ± 6 years, 56% were women, and 81% were white. At 17 ± 6 years of follow-up, HF occurred in 14%, CHD 11%, stroke 6%, and the composite in 24%. Rapid decline in FEV1 and in FVC were both associated with a heightened risk of incident HF (hazard ratio [HR]: 1.17; 95% confidence interval [CI]: 1.04 to 1.33; p = 0.010; and HR: 1.27; 95% CI: 1.12 to 1.44; p < 0.001; respectively), with rapid decline in FEV1 most prognostic in the first year of follow-up (HR: 4.22; 95% CI: 1.34 to 13.26; p = 0.01). Rapid decline in FEV1 was also associated with incident stroke (HR: 1.25; 95% CI: 1.04 to 1.50; p = 0.015). CONCLUSIONS A rapid decline in lung function, assessed by serial spirometry, is associated with a higher incidence of subsequent CVD, particularly incident HF.
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Affiliation(s)
- Odilson M Silvestre
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Internal Medicine, Federal University of Acre, Rio Branco, Acre, Brazil
| | - Wilson Nadruz
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Internal Medicine, University of Campinas, Campinas, Brazil
| | | | - Brian Claggett
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Scott D Solomon
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Stephanie J London
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
| | - Laura R Loehr
- Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Amil M Shah
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
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23
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Duprez DA, Jacobs DR. Lung Function Decline and Increased Cardiovascular Risk: Quo Vadis. J Am Coll Cardiol 2018; 72:1123-1125. [PMID: 30165983 DOI: 10.1016/j.jacc.2018.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 07/09/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Daniel A Duprez
- Cardiovascular Division, School of Medicine, University of Minnesota, Minneapolis, Minnesota.
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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24
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Amaral AFS, Quint JK. Cottage by the sea or house above the trees: which is better for my lungs? Thorax 2018; 73:1103-1104. [PMID: 30166423 DOI: 10.1136/thoraxjnl-2018-212146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Andre F S Amaral
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jennifer K Quint
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
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Keet CA, McCormack M. Cardiac Asthma: An Old Term That May Have New Meaning? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 4:924-5. [PMID: 27587322 DOI: 10.1016/j.jaip.2016.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Corinne A Keet
- Division of Pediatric Allergy and Immunology, Johns Hopkins School of Medicine, Baltimore, Md.
| | - Meredith McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Md
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26
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Pan J, Xu L, Lam TH, Jiang CQ, Zhang WS, Zhu F, Jin YL, Neil Thomas G, Cheng KK, Adab P. Relationship between pulmonary function and peripheral vascular function in older Chinese: Guangzhou biobank cohort study-CVD. BMC Pulm Med 2018; 18:74. [PMID: 29783975 PMCID: PMC5963074 DOI: 10.1186/s12890-018-0649-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Findings describing the relationship between pulmonary function and peripheral vascular function have been inconclusive. We explored this relationship in Guangzhou Biobank Cohort Study-Cardiovascular Subcohort (GBCS-CVD). METHODS Brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI) were measured by a waveform analyser, and pulmonary function by turbine flowmeter spirometry. Predicted forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were derived using equations for Chinese. Regression analyses were used to investigate the association. RESULTS Of 1528 older Chinese, 980 (64.1%) had arterial stiffness (baPWV ≥1400 cm/s), but only 29 (1.9%) had peripheral arterial disease (PAD) (ABI < 0.9). The mean (±standard deviation, SD) baPWV was 1547 (±298) cm/s and mean (±SD) ABI 1.09 (±0.09). Before and after adjusting for potential confounders, baPWV was negatively associated with FEV1 and FVC % predicted (% predicted = observed/predicted × 100%) (adjusted β: - 0.95 and - 1.16 respectively, p < 0.05), and ABI was marginally non-significantly positively associated with FEV1% predicted (adjusted β 0.02, p = 0.32) and FVC% predicted (adjusted β 0.02, p = 0.18). Compared to participants in the highest tertile of pulmonary function, those in the lowest had higher risk of arterial stiffness (adjusted odds ratio (AOR) 1.51, 95% CI 1.09-2.10 for FEV1 and AOR 1.69, 95% CI 1.22-2.33 for FVC), but the higher risk of PAD was marginally non-significant (AOR 1.64, p = 0.42 for FEV1 and AOR 1.65, p = 0.24 for FVC). CONCLUSION In older relatively healthy normal weight Chinese, pulmonary function was inversely dose-dependently associated with arterial stiffness, while the association with PAD was much weaker.
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Affiliation(s)
- Jing Pan
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Tai Hing Lam
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | | | - Wei Sen Zhang
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
| | - Feng Zhu
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
| | - Ya Li Jin
- Guangzhou No.12 Hospital, Guangzhou, Guangdong China
| | - G. Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Peterson TE, Huppler Hullsiek K, Wyman Engen N, Kumarasamy N, Lebech AM, Liappis A, Papadopoulos A, Polizzotto MN, Schreiner PJ, Duprez D, Baker JV. Inflammation Associates With Impaired Small Arterial Elasticity Early in HIV Disease. Open Forum Infect Dis 2018; 5:ofy117. [PMID: 29942822 PMCID: PMC6007791 DOI: 10.1093/ofid/ofy117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/17/2018] [Indexed: 01/26/2023] Open
Abstract
We estimated small arterial elasticity and used linear regression to evaluate its association with inflammatory biomarkers among antiretroviral therapy–naïve, HIV-positive patients with high CD4+ counts. After adjustment, high-sensitivity C-reactive protein and interleukin-6 were inversely associated with small arterial elasticity. These data suggest that systemic inflammation may contribute to vascular dysfunction even in very early HIV disease.
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Affiliation(s)
| | | | - Nicole Wyman Engen
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota
| | | | - Anne-Mette Lebech
- Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Angelike Liappis
- Section of Infectious Diseases, Washington DC Veterans Affairs Medical Center, Washington, DC
| | - Antonios Papadopoulos
- 4th Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Mark N Polizzotto
- Kirby Institute for Infection and Immunity, University of New South Wales, Sydney, Australia
| | | | - Daniel Duprez
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Jason V Baker
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota.,Infectious Diseases, Hennepin County Medical Center, Minneapolis, Minesota
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Wu IH, Wu JS. Response. Chest 2018; 153:570. [DOI: 10.1016/j.chest.2017.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 10/18/2022] Open
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FEV 1 and FVC and systemic inflammation in a spinal cord injury cohort. BMC Pulm Med 2017; 17:113. [PMID: 28810847 PMCID: PMC5558736 DOI: 10.1186/s12890-017-0459-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 08/08/2017] [Indexed: 12/30/2022] Open
Abstract
Background Systemic inflammation has been associated with reduced pulmonary function in individuals with and without chronic medical conditions. Individuals with chronic spinal cord injury (SCI) have clinical characteristics that promote systemic inflammation and also have reduced pulmonary function. We sought to assess the associations between biomarkers of systemic inflammation with pulmonary function in a chronic SCI cohort, adjusting for other potential confounding factors. Methods Participants (n = 311) provided a blood sample, completed a respiratory health questionnaire, and underwent spirometry. Linear regression methods were used to assess cross-sectional associations between plasma C-reactive protein (CRP) and interleukin-6 (IL-6) with forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC. Results There were statistically significant inverse relationships between plasma CRP and IL-6 assessed in quartiles or continuously with FEV1 and FVC. In fully adjusted models, each interquartile range (5.91 mg/L) increase in CRP was associated with a significant decrease in FEV1 (−55.85 ml; 95% CI: -89.21, −22.49) and decrease in FVC (−65.50 ml; 95% CI: -106.61, −24.60). There were similar significant findings for IL-6. There were no statistically significant associations observed with FEV1/FVC. Conclusion Plasma CRP and IL-6 in individuals with chronic SCI are inversely associated with FEV1 and FVC, independent of SCI level and severity of injury, BMI, and other covariates. This finding suggests that systemic inflammation associated with chronic SCI may contribute to reduced pulmonary function. Electronic supplementary material The online version of this article (doi:10.1186/s12890-017-0459-6) contains supplementary material, which is available to authorized users.
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30
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Bhatia S, Qualls C, Crowell TA, Arynchyn A, Thyagarajan B, Smith LJ, Kalhan R, Jacobs DR, Kramer H, Duprez D, Celli B, Sood A. Rapid decline in lung function in healthy adults predicts incident excess urinary albumin excretion later in life. BMJ Open Respir Res 2017; 4:e000194. [PMID: 29071073 PMCID: PMC5647541 DOI: 10.1136/bmjresp-2017-000194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 06/15/2017] [Indexed: 12/16/2022] Open
Abstract
Introduction Chronic lung disease, often characterised by rapid decline in lung function, is associated with vascular endothelial dysfunction (characterised by moderate to severe excess urinary albumin excretion (eUAE) but their longitudinal relationship is inadequately studied. In a bidirectional longitudinal examination of healthy adults, we analysed the following two hypotheses: (1) rapid decline (ie, highest tertile of lung function decline) predicts eUAE and (2) eUAE predicts rapid decline. Methods We performed a secondary data analysis from 3052 eligible participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. For analysis 1, the predictor was rapid decline in lung function between the peak value (attained at or before CARDIA visit year 10 or Y10 at a mean age of 35 years) and Y20; and the outcome was incident eUAE at Y20 and/or Y25. For analysis 2, the predictor was eUAE at Y10 and the outcome was rapid decline between Y10 and Y20. Results After adjustment for covariates in analysis 1, rapid decline in FEV1 or FVC between peak and Y20 predicted incident eUAE at Y20 and/or Y25 (OR 1.51 and 1.44, respectively; p≤0.05 for both analyses). In analysis 2, eUAE at Y10 did not predict subsequent rapid decline. Conclusions Healthy adults with rapid decline in lung function are at risk for developing vascular endothelial dysfunction, as assessed by incident eUAE, later in life.
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Affiliation(s)
- Sapna Bhatia
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Clifford Qualls
- Office of Research, Clinical Translational Science Center,University of New Mexico, Albuquerque, New Mexico, USA
| | - Thomas A Crowell
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Alexander Arynchyn
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, USA
| | - Lewis J Smith
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ravi Kalhan
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Holly Kramer
- Department of Medicine, Loyola University School of Medicine, Maywood, Illinois, USA
| | - Daniel Duprez
- Department of Medicine, University of Minnesota, Minneapolis, USA
| | | | - Akshay Sood
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
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Cuttica MJ, Bhatt SP, Rosenberg SR, Beussink L, Shah SJ, Smith LJ, Dransfield MT, Kalhan R. Pulmonary artery to aorta ratio is associated with cardiac structure and functional changes in mild-to-moderate COPD. Int J Chron Obstruct Pulmon Dis 2017; 12:1439-1446. [PMID: 28553096 PMCID: PMC5439958 DOI: 10.2147/copd.s131413] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background The ratio of the diameter of the pulmonary artery (PA) to the diameter of the aorta (PA:A) on computed tomography (CT) imaging is associated with both COPD exacerbation and pulmonary hypertension. The mechanisms of PA enlargement in COPD are poorly understood. Methods In this retrospective, single center study we evaluated pulmonary function, CT scans, right heart catheterizations, and echocardiography in 88 subjects with mild-to-moderately severe COPD. A sensitivity analysis was performed in 43 subjects in whom CT scan and echocardiogram were performed within 50 days of each other. To evaluate the association between PA:A ratio and echocardiographic parameters and hemodynamics, we performed simple correlations and multivariable linear regression analysis adjusting for lung function, age, sex, race, and diastolic function. Results All subjects had preserved left ventricular (LV) systolic function (LV ejection fraction 62.7%±5.5%). Among them, 56.8% had evidence of diastolic dysfunction. There was no association between PA:A ratio and the presence of diastolic dysfunction. In a multivariable model, PA:A ratio was associated with right ventricular (RV) chamber size (β=0.015; P<0.003), RV wall thickness (β=0.56; P<0.002), and RV function (−0.49; P=0.05). In the subgroup of subjects with testing within 50 days, the association with RV chamber size persisted (β=0.017; P=0.04), as did the lack of association with diastolic function. PA:A ratio was also associated with elevated PA systolic pressures (r=0.62; P=0.006) and pulmonary vascular resistance (r=0.46; P=0.05), but not pulmonary arterial wedge pressure (r=0.17; P=0.5) in a subset of patients undergoing right heart catheterization. Conclusion In patients with mild-to-moderately severe COPD and preserved LV function, increased PA:A ratio occurs independent of LV diastolic dysfunction. Furthermore, the PA:A ratio is associated with right heart structure and function changes, as well as pulmonary hemodynamics. These findings indicate that PA:A ratio is a marker of intrinsic pulmonary vascular changes rather than impaired LV filling.
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Affiliation(s)
- Michael J Cuttica
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Surya P Bhatt
- Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama-Birmingham, Birmingham, AL
| | - Sharon R Rosenberg
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lauren Beussink
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sanjiv J Shah
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lewis J Smith
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Mark T Dransfield
- Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama-Birmingham, Birmingham, AL
| | - Ravi Kalhan
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
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Wu IH, Sun ZJ, Lu FH, Yang YC, Chou CY, Chang CJ, Wu JS. Restrictive Spirometry Pattern Is Associated With Increased Arterial Stiffness in Men and Women. Chest 2017; 152:394-401. [PMID: 28411113 DOI: 10.1016/j.chest.2017.03.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 03/18/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND There is growing evidence that pulmonary function impairment is related to cardiovascular events and death. Some studies have shown that the level of FVC is negatively related to arterial stiffness, but most studies were confined to men, and none of them examined the association of the presence of restrictive spirometry pattern with arterial stiffness. Therefore, this study aimed to investigate the association of restrictive spirometry pattern with arterial stiffness by sex. METHODS This study recruited 2,961 subjects after excluding those with (1) obstructive lung disease, as defined by history and pulmonary function test; (2) history of asthma, lung cancer, tuberculosis, coronary heart disease, stroke, or any pulmonary structural deformities; and (3) medications influencing BP, plasma glucose, lipid profile, and pulmonary function test. Restrictive spirometry pattern was diagnosed as an FVC < 80% of the predicted value and an FEV1/FVC ratio ≥ 70%. Increased arterial stiffness was defined as right brachial ankle pulse wave velocity (baPWV) ≥ 1,400 cm/s. RESULTS In both men and women, FVC was negatively associated with the baPWV level. Restrictive spirometry pattern was positively associated with increased arterial stiffness in both men and women (men: OR, 2.16; 95% CI, 1.33-3.50; women: OR, 1.95; 95% CI, 1.02-3.72) after adjustment for other clinical variables. CONCLUSIONS Both restrictive spirometry pattern and reduced FVC were associated with a higher risk of arterial stiffness, not only in men but also in women. Clinically, assessment of arterial stiffness might be considered in individuals with restrictive spirometry pattern.
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Affiliation(s)
- I-Hsuan Wu
- Department of Family Medicine, National Cheng Kung University, Taiwan, China
| | - Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University, Taiwan, China; Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Taiwan, China
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University, Taiwan, China; College of Medicine, National Cheng Kung University, Taiwan, China
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University, Taiwan, China; College of Medicine, National Cheng Kung University, Taiwan, China
| | - Chieh-Ying Chou
- Department of Family Medicine, National Cheng Kung University, Taiwan, China
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University, Taiwan, China; College of Medicine, National Cheng Kung University, Taiwan, China
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University, Taiwan, China; College of Medicine, National Cheng Kung University, Taiwan, China.
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33
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Hoogeveen EK, Geleijnse JM, Giltay EJ, Soedamah-Muthu SS, de Goede J, Oude Griep LM, Stijnen T, Kromhout D. Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients: A 10-year follow-up study. PLoS One 2017; 12:e0171868. [PMID: 28182761 PMCID: PMC5300181 DOI: 10.1371/journal.pone.0171868] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 01/26/2017] [Indexed: 01/08/2023] Open
Abstract
Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002-2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR) with cystatin C (cysC) and creatinine (cr) using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD) for age was 69 years (5.6), 79% were men, 17% smoked, 21% had diabetes, 90% used antihypertensive drugs, 98% used antithrombotic drugs and 85% used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33%; reference), 60-89 (47%), 30-59 (18%), and <30 (2%) ml/min/1.73m2. Median follow-up was 6.4 years. During follow-up, 873 (19%) patients died: 370 (42%) from cardiovascular causes, 309 (35%) from cancer, and 194 (22%) from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95%-confidence intervals) for any death according to the four eGFRcysC categories were: 1 (reference), 1.4 (1.1-1.7), 2.9 (2.3-3.6) and 4.4 (3.0-6.4). The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2.
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Affiliation(s)
- Ellen K. Hoogeveen
- Department of Nephrology, Jeroen Bosch Hospital, Den Bosch, the Netherlands
- Department of Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Erik J. Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Janette de Goede
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Linda M. Oude Griep
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Theo Stijnen
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands
| | - Daan Kromhout
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
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Pulmonary Function and Arterial Stiffness in Chronic Heart Failure. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5478394. [PMID: 28097138 PMCID: PMC5209595 DOI: 10.1155/2016/5478394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/28/2016] [Accepted: 11/30/2016] [Indexed: 12/21/2022]
Abstract
Arterial stiffness contributes to heart failure and is decreased by angiotensin receptor blockers (ARBs). This cross-sectional study aimed to assess associations of lung function and ARB with arterial stiffness in patients with chronic heart failure. 354 outpatients (168 males; 186 females; 68.2 ± 7.2 years old) with chronic heart failure were evaluated. Lung function parameters, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1 to FVC ratio (FEV1/FVC), were assessed. The cardio-ankle vascular index (CAVI) was used to estimate arterial stiffness. Unadjusted correlation analyses revealed a positive association of CAVI with ARB but not ACEI, and a negative correlation with FEV1 (r = −0.2987, p < 0.0001). Multiple stepwise regression analyses showed that ARB and FEV1 (p < 0.0001) were independent predicting factors for CAVI. These findings suggest that reduced pulmonary function is associated with increased CAVI. Pulmonary function protection could be used to improve the prognosis in heart failure, but additional studies are necessary.
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McAllister DA, Newby DE. Association between Impaired Lung Function and Cardiovascular Disease. Cause, Effect, or Force of Circumstance? Am J Respir Crit Care Med 2016; 194:3-5. [DOI: 10.1164/rccm.201601-0167ed] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hart JE, Morse L, Tun CG, Brown R, Garshick E. Cross-sectional associations of pulmonary function with systemic inflammation and oxidative stress in individuals with chronic spinal cord injury. J Spinal Cord Med 2016; 39:344-52. [PMID: 26180939 PMCID: PMC5073753 DOI: 10.1179/2045772315y.0000000045] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
CONTEXT/OBJECTIVE Systemic inflammation, and to a lesser extent oxidative stress, have been associated with reduced pulmonary function. Our objective was to evaluate the associations between biomarkers of inflammation (C-reactive protein (CRP), interleukin-6 (IL-6)) and novel makers of global oxidative stress (fluorescent oxidation products (FLOx)) with spirometric and lung volume measures in individuals with chronic spinal cord injury (SCI). DESIGN Cross-sectional study. SETTING Veterans Affairs Medical Center. PARTICIPANTS One-hundred thirty-seven men with chronic SCI participating in an epidemiologic study. METHODS Participants provided a blood sample, completed health questionnaires, and underwent pulmonary function testing, including helium dilution measurement of functional residual capacity (FRC). General linear models were used to model associations between increasing quartiles of inflammation or oxidative stress with each outcome measure, after adjustment for a number of potential confounders. OUTCOME MEASURES Percent-predicted forced vital capacity in one second (FEV1), percent-predicted forced vital capacity (FVC), FEV1/FVC, percent-predicted residual volume (RV), percent-predicted FRC, and percent-predicted total lung capacity (TLC). RESULTS After adjustment for a number of confounders, participants with higher levels of CRP and IL-6 had lower percent-predicted FEV1 and FVC measurements. There were no clear patterns of association with any of the oxidative stress biomarkers or other outcome measures. CONCLUSION Increased systemic inflammation was associated with reductions in FEV1 and FVC independent of a number of covariates. Although the mechanism is uncertain, these results suggest that reductions in pulmonary function in SCI are associated with systemic inflammation.
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Affiliation(s)
- Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Leslie Morse
- Spaulding-Harvard SCI Model System, Spaulding Rehabilitation Hospital and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA, USA
| | - Carlos G. Tun
- Rehabilitation Medicine Service, VA Boston Healthcare System, West Roxbury, MA, USA
| | - Robert Brown
- Pulmonary and Critical Care Medicine Unit and Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Eric Garshick
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,Pulmonary and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, West Roxbury, MA, USA,Correspondence to: Eric Garshick, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA, 02132 USA.
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Booth JN, Redmond N, Sims M, Shimbo D, Muntner P. The association of reduced lung function with blood pressure variability in African Americans: data from the Jackson Heart Study. BMC Cardiovasc Disord 2016; 16:6. [PMID: 26754344 PMCID: PMC4709870 DOI: 10.1186/s12872-015-0182-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 12/24/2015] [Indexed: 11/10/2022] Open
Abstract
Background African Americans (AAs) have lower lung function, higher blood pressure variability (BPV) and increased risk for hypertension and cardiovascular disease (CVD) compared with whites. The mechanism through which reduced lung-function is associated with increased CVD risk is unclear. Methods We evaluated the association between percent predicted lung-function and 24-hour BPV in 1008 AAs enrolled in the Jackson Heart Study who underwent ambulatory blood pressure (BP) monitoring. Lung-function was assessed as forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and the ratio of FEV1-to-FVC during a pulmonary function test using a dry rolling sealed spirometer and grouped into gender-specific quartiles. The pairwise associations of these three lung-function measures with two measures of 24-hour BPV, (1) day-night standard deviation (SDdn) and (2) average real variability (ARV) were examined for systolic BP (SBP) and, separately, diastolic BP (DBP). Results SDdn of SBP was not associated with FEV1 (mean ± standard deviation from lowest-to-highest quartile: 9.5 ± 2.5, 9.4 ± 2.4, 9.1 ± 2.3, 9.3 ± 2.6; p-trend = 0.111). After age and sex adjustment, the difference in SDdn of SBP was 0.0 (95 % CI −0.4,0.4), −0.4 (95 % CI −0.8,0.1) and −0.3 (95 % CI −0.7,0.1) in the three progressively higher versus lowest quartiles of FEV1 (p-trend = 0.041). Differences in SDdn of SBP across FEV1 quartiles were not statistically significant after further multivariable adjustment. After multivariable adjustment, no association was present between FEV1 and ARV of SBP or SDdn and ARV of DBP or when evaluating the association of FVC and FEV1-to-FVC with 24-hour BPV. Conclusion Lung-function was not associated with increased 24-hour BPV. Electronic supplementary material The online version of this article (doi:10.1186/s12872-015-0182-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- John N Booth
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nicole Redmond
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mario Sims
- University of Mississippi Medical Center, Jackson, MS, USA
| | - Daichi Shimbo
- Columbia University Medical Center, New York, NY, USA
| | - Paul Muntner
- University of Alabama at Birmingham, Birmingham, AL, USA. .,Department of Epidemiology, University of Alabama at Birmingham, 1700 University Boulevard, LHL 440, Birmingham, AL, 35294, USA.
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Association of pulse wave velocity with total lung capacity: A cross-sectional analysis of the BOLD London study. Respir Med 2015; 109:1569-75. [PMID: 26553156 PMCID: PMC4687496 DOI: 10.1016/j.rmed.2015.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/15/2015] [Accepted: 10/28/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Low lung function, measured using spirometry, has been associated with mortality from cardiovascular disease, but whether this is explained by airflow obstruction or restriction is a question that remains unanswered. OBJECTIVES To assess the association of total lung capacity (TLC), forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) with several cardio-metabolic and inflammatory markers. METHODS In the follow up of the Burden of Lung Disease (BOLD) study in London, acceptable post-bronchodilator spirometric, pulse rate, pulse wave velocity and blood pressure data were obtained from 108 participants. Blood samples for measurement of cardio-metabolic and inflammatory markers were also collected from these participants. Association of lung function and volume with the different biomarkers was examined in multivariable linear regression models adjusted for potential confounders. RESULTS Following adjustment for age, sex, height, and ethnicity, TLC (adjusted coefficient = -1.53; 95% CI: -2.57, -0.49) and FVC (adjusted coefficient = -2.66; 95% CI: -4.98, -0.34) were inversely associated with pulse wave velocity, and further adjustment for smoking status, pack-years and body mass index (BMI) did not materially change these results. FEV1 was inversely associated with systolic blood pressure, and adjustment for smoking status, pack-years and BMI made this association stronger (adjusted coefficient = -9.47; 95% CI: -15.62, -3.32). CONCLUSION The inverse association of pulse wave velocity, which is a marker of cardiovascular disease, with TLC suggests that the association of the former with low FVC is independent of airflow obstruction. The association between FEV1 with systolic blood pressure after adjustment for FVC suggests an association with airflow obstruction rather than with restricted spirometry.
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van Rooyen Y, Schutte AE, Huisman HW, Eloff FC, Du Plessis JL, Kruger A, van Rooyen JM. Inflammation as Possible Mediator for the Relationship Between Lung and Arterial Function. Lung 2015; 194:107-15. [DOI: 10.1007/s00408-015-9804-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/18/2015] [Indexed: 11/28/2022]
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40
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Cuttica MJ, Colangelo LA, Shah SJ, Lima J, Kishi S, Arynchyn A, Jacobs DR, Thyagarajan B, Liu K, Lloyd-Jones D, Kalhan R. Loss of Lung Health from Young Adulthood and Cardiac Phenotypes in Middle Age. Am J Respir Crit Care Med 2015; 192:76-85. [PMID: 25876160 PMCID: PMC4511426 DOI: 10.1164/rccm.201501-0116oc] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/12/2015] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Chronic lung diseases are associated with cardiovascular disease. How these associations evolve from young adulthood forward is unknown. Understanding the preclinical history of these associations could inform prevention strategies for common heart-lung conditions. OBJECTIVES To use the Coronary Artery Risk Development in Young Adults (CARDIA) study to explore the development of heart-lung interactions. METHODS We analyzed cardiac structural and functional measurements determined by echocardiography at Year 25 of CARDIA and measures of pulmonary function over 20 years in 3,000 participants. MEASUREMENTS AND MAIN RESULTS Decline in FVC from peak was associated with larger left ventricular mass (β = 6.05 g per SD of FVC decline; P < 0.0001) and greater cardiac output (β = 0.109 L/min per SD of FVC decline; P = 0.001). Decline in FEV1/FVC ratio was associated with smaller left atrial internal dimension (β = -0.038 cm per SD FEV1/FVC decline; P < 0.0001) and lower cardiac output (β = -0.070 L/min per SD of FEV1/FVC decline; P = 0.03). Decline in FVC was associated with diastolic dysfunction (odds ratio, 3.39; 95% confidence interval, 1.37-8.36; P = 0.006). CONCLUSIONS Patterns of loss of lung health are associated with specific cardiovascular phenotypes in middle age. Decline in FEV1/FVC ratio is associated with underfilling of the left heart and low cardiac output. Decline in FVC with preserved FEV1/FVC ratio is associated with left ventricular hypertrophy and diastolic dysfunction. Cardiopulmonary interactions apparent with common complex heart and lung diseases evolve concurrently from early adulthood forward.
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Affiliation(s)
| | | | | | - Joao Lima
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Satoru Kishi
- Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alexander Arynchyn
- Division of Preventive Medicine, University of Alabama, Birmingham, Alabama
| | - David R. Jacobs
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota; and
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, Minnesota
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Donald Lloyd-Jones
- Division of Cardiology, and
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ravi Kalhan
- Division of Pulmonary and Critical Care Medicine
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Burroughs Peña M, Romero KM, Velazquez EJ, Davila-Roman VG, Gilman RH, Wise RA, Miranda JJ, Checkley W. Relationship between daily exposure to biomass fuel smoke and blood pressure in high-altitude Peru. Hypertension 2015; 65:1134-40. [PMID: 25753976 DOI: 10.1161/hypertensionaha.114.04840] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 02/13/2015] [Indexed: 01/08/2023]
Abstract
Household air pollution from biomass fuel use affects 3 billion people worldwide; however, few studies have examined the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with elevated blood pressure in high altitude Peru and if this relationship was affected by lung function. We analyzed baseline information from a population-based cohort study of adults aged ≥ 35 years in Puno, Peru. Daily biomass fuel use was self-reported. We used multivariable regression models to examine the relationship between daily exposure to biomass fuel smoke and blood pressure outcomes. Interactions with sex and quartiles of forced vital capacity were conducted to evaluate for effect modification. Data from 1004 individuals (mean age, 55.3 years; 51.7% women) were included. We found an association between biomass fuel use with both prehypertension (adjusted relative risk ratio, 5.0; 95% confidence interval, 2.6-9.9) and hypertension (adjusted relative risk ratio, 3.5; 95% confidence interval, 1.7-7.0). Biomass fuel users had a higher systolic blood pressure (7.0 mm Hg; 95% confidence interval, 4.4-9.6) and a higher diastolic blood pressure (5.9 mm Hg; 95% confidence interval, 4.2-7.6) when compared with nonusers. We did not find interaction effects between daily biomass fuel use and sex or percent predicted forced vital capacity for either systolic blood pressure or diastolic blood pressure. Biomass fuel use was associated with a higher likelihood of having hypertension and higher blood pressure in Peru. Reducing exposure to household air pollution from biomass fuel use represents an opportunity for cardiovascular prevention.
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Affiliation(s)
- Melissa Burroughs Peña
- From the Division of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, NC (M.B.P., E.J.V.); Biomedical Research Unit, A.B. PRISMA, Lima, Peru (K.M.R.); Division of Cardiology, Department of Medicine, Washington University, St. Louis, MO (V.G.D.-R.); Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health (R.H.G.) and Division of Pulmonary and Critical Care Medicine, School of Medicine (R.A.W., W.C.), Johns Hopkins University, Baltimore, MD; and CRONICAS Center of Excellence in Chronic Diseases (R.H.G., J.J.M., W.C.) and Department of Medicine (J.J.M.), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Karina M Romero
- From the Division of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, NC (M.B.P., E.J.V.); Biomedical Research Unit, A.B. PRISMA, Lima, Peru (K.M.R.); Division of Cardiology, Department of Medicine, Washington University, St. Louis, MO (V.G.D.-R.); Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health (R.H.G.) and Division of Pulmonary and Critical Care Medicine, School of Medicine (R.A.W., W.C.), Johns Hopkins University, Baltimore, MD; and CRONICAS Center of Excellence in Chronic Diseases (R.H.G., J.J.M., W.C.) and Department of Medicine (J.J.M.), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eric J Velazquez
- From the Division of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, NC (M.B.P., E.J.V.); Biomedical Research Unit, A.B. PRISMA, Lima, Peru (K.M.R.); Division of Cardiology, Department of Medicine, Washington University, St. Louis, MO (V.G.D.-R.); Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health (R.H.G.) and Division of Pulmonary and Critical Care Medicine, School of Medicine (R.A.W., W.C.), Johns Hopkins University, Baltimore, MD; and CRONICAS Center of Excellence in Chronic Diseases (R.H.G., J.J.M., W.C.) and Department of Medicine (J.J.M.), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Victor G Davila-Roman
- From the Division of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, NC (M.B.P., E.J.V.); Biomedical Research Unit, A.B. PRISMA, Lima, Peru (K.M.R.); Division of Cardiology, Department of Medicine, Washington University, St. Louis, MO (V.G.D.-R.); Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health (R.H.G.) and Division of Pulmonary and Critical Care Medicine, School of Medicine (R.A.W., W.C.), Johns Hopkins University, Baltimore, MD; and CRONICAS Center of Excellence in Chronic Diseases (R.H.G., J.J.M., W.C.) and Department of Medicine (J.J.M.), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H Gilman
- From the Division of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, NC (M.B.P., E.J.V.); Biomedical Research Unit, A.B. PRISMA, Lima, Peru (K.M.R.); Division of Cardiology, Department of Medicine, Washington University, St. Louis, MO (V.G.D.-R.); Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health (R.H.G.) and Division of Pulmonary and Critical Care Medicine, School of Medicine (R.A.W., W.C.), Johns Hopkins University, Baltimore, MD; and CRONICAS Center of Excellence in Chronic Diseases (R.H.G., J.J.M., W.C.) and Department of Medicine (J.J.M.), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert A Wise
- From the Division of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, NC (M.B.P., E.J.V.); Biomedical Research Unit, A.B. PRISMA, Lima, Peru (K.M.R.); Division of Cardiology, Department of Medicine, Washington University, St. Louis, MO (V.G.D.-R.); Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health (R.H.G.) and Division of Pulmonary and Critical Care Medicine, School of Medicine (R.A.W., W.C.), Johns Hopkins University, Baltimore, MD; and CRONICAS Center of Excellence in Chronic Diseases (R.H.G., J.J.M., W.C.) and Department of Medicine (J.J.M.), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J Jaime Miranda
- From the Division of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, NC (M.B.P., E.J.V.); Biomedical Research Unit, A.B. PRISMA, Lima, Peru (K.M.R.); Division of Cardiology, Department of Medicine, Washington University, St. Louis, MO (V.G.D.-R.); Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health (R.H.G.) and Division of Pulmonary and Critical Care Medicine, School of Medicine (R.A.W., W.C.), Johns Hopkins University, Baltimore, MD; and CRONICAS Center of Excellence in Chronic Diseases (R.H.G., J.J.M., W.C.) and Department of Medicine (J.J.M.), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - William Checkley
- From the Division of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, NC (M.B.P., E.J.V.); Biomedical Research Unit, A.B. PRISMA, Lima, Peru (K.M.R.); Division of Cardiology, Department of Medicine, Washington University, St. Louis, MO (V.G.D.-R.); Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health (R.H.G.) and Division of Pulmonary and Critical Care Medicine, School of Medicine (R.A.W., W.C.), Johns Hopkins University, Baltimore, MD; and CRONICAS Center of Excellence in Chronic Diseases (R.H.G., J.J.M., W.C.) and Department of Medicine (J.J.M.), Universidad Peruana Cayetano Heredia, Lima, Peru.
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Pepin JL, Cockcroft JR, Midwinter D, Sharma S, Rubin DB, Andreas S. Long-acting bronchodilators and arterial stiffness in patients with COPD: a comparison of fluticasone furoate/vilanterol with tiotropium. Chest 2015; 146:1521-1530. [PMID: 25058845 DOI: 10.1378/chest.13-2859] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Increased arterial stiffness as measured by aortic pulse wave velocity (aPWV) predicts cardiovascular events and mortality and is elevated in patients with COPD. Prior investigation suggests that a long-acting β-agonist (LABA)/inhaled corticosteroid (ICS) lowers aPWV in patients with baseline aPWV ≥ 11 m/s. This study compared the effect of the ICS/LABA fluticasone furoate/vilanterol (FF/VI), 100/25 μg, delivered via the ELLIPTA dry powder inhaler, with tiotropium bromide (TIO), 18 μg, on aPWV. METHODS This multicenter, randomized, blinded, double-dummy, parallel-group, 12-week study compared FF/VI and TIO, both administered once daily. The primary end point was aPWV change from baseline at 12 weeks. Safety end points included adverse events (AEs), vital signs, and clinical laboratory tests. RESULTS Two hundred fifty-seven patients with COPD and aPWV ≥ 11 m/s were randomized; 87% had prior cardiovascular events and/or risk. The mean difference in aPWV between FF/VI and TIO at week 12 was not significant (P = .484). Because the study did not contain a placebo arm, a post hoc analysis was performed to show that both treatments lowered aPWV by an approximate difference of 1 m/s compared with baseline. The proportion of patients reporting AEs was similar with FF/VI (24%) and TIO (18%). There were no changes in clinical concern for vital signs or clinical laboratory tests. CONCLUSIONS No differences on aPWV were observed between FF/VI and TIO. However, further studies with a placebo arm are required to establish definitively whether long-acting bronchodilators lower aPWV. Both treatments demonstrated an acceptable tolerability profile. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01395888; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Jean-Louis Pepin
- University Grenoble Alpes, Grenoble University Hospital, Grenoble, France
| | - John R Cockcroft
- Wales Heart Research Institute, Cardiff University, Cardiff, Wales
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Grim status of hypertension in rural China: results from Northeast China Rural Cardiovascular Health Study 2013. ACTA ACUST UNITED AC 2015; 9:358-64. [PMID: 25863573 DOI: 10.1016/j.jash.2015.02.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 02/10/2015] [Accepted: 02/11/2015] [Indexed: 01/05/2023]
Abstract
The last study that reported the prevalence of hypertension in rural Northeast China was conducted approximately 10 years ago. We aimed to update the data on the prevalence and epidemiologic features of hypertension in rural Northeast China. This study examined a total of 11,576 adults using a multi-stage cluster sampling method to select a representative sample of individuals 35 years or older. Sitting blood pressure was measured three times for each participant by trained observers using a standardized electric sphygmomanometer after resting for 5 minutes. Related medical histories were obtained using a standard questionnaire, and blood biochemical indexes were collected by well-trained personnel. Prevalence of hypertension was 51.1%; 53.9% for men and 48.7% for women. Among subjects with hypertension, 43.5% were aware of the diagnosis, and 31.2% were taking antihypertensive medications, but only 6% had their blood pressure controlled. Besides traditional risk factors, multiple logistic regression analysis indicated that obesity, diabetes, dyslipidemia, and hyperuricemia were becoming risk factors for hypertension in this rural area.The status of hypertension is grim currently in rural Northeast China. The prevalence of hypertension remains seriously high, while the control rate is still frustratingly low. Obesity, diabetes, dyslipidemia, and hyperuricemia were more likely to be associated with hypertension in this rural area.
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Affiliation(s)
- Ralf P. Brandes
- From the Fachbereich Medizin der Goethe-Universität, Institut für Kardiovaskuläre Physiologie, Frankfurt am Main, Germany
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Kals J, Lieberg J, Kampus P, Zagura M, Eha J, Zilmer M. Prognostic impact of arterial stiffness in patients with symptomatic peripheral arterial disease. Eur J Vasc Endovasc Surg 2014; 48:308-15. [PMID: 24962743 DOI: 10.1016/j.ejvs.2014.05.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 05/15/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Arterial stiffness (AS) is increasingly recognized as an independent risk factor in different high-risk populations. Whether changes in AS can predict prognosis in patients with symptomatic peripheral arterial disease (PAD) has never been investigated. The aim of the present study was to test the hypothesis that AS is an independent predictor of all-cause and cardiovascular disease (CVD) mortality in patients with symptomatic PAD. METHODS A cohort of 117 symptomatic PAD patients (aged 62.3 ± 7.7 years) were prospectively recruited from the Department of Vascular Surgery, Tartu University Hospital, between 2002 and 2010. The AS was measured using pulse wave analysis and assessment of pulse wave velocity (PWV). RESULTS During the follow-up period (mean 4.1 ± 2.2 years) there were 32 fatal events. Kaplan-Meier analysis showed that the probability of all-cause and CVD mortality decreased with increasing small artery elasticity (SAE), as estimated by the log-rank test (p = .004; p = .005, respectively). By contrast, large artery elasticity, augmentation index, and aortic and brachial PWV were not significantly related to mortality. In a Cox proportional hazard model, SAE above the median was associated with decreased all-cause and CVD mortality after adjustment for confounding factors: relative risk (RR), 0.37; 95% confidence interval (CI), 0.17-0.81; p = .01; RR, 0.11; 95% CI, 0.01-0.86; p = .04, respectively). CONCLUSIONS This study provides the first evidence, obtained from an observational study, that decreased small artery elasticity is an independent predictor of all-cause and CVD mortality in patients with symptomatic PAD.
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Affiliation(s)
- J Kals
- Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia; Endothelial Centre, University of Tartu, Tartu, Estonia; Department of Vascular Surgery, Tartu University Hospital, Tartu, Estonia.
| | - J Lieberg
- Department of Vascular Surgery, Tartu University Hospital, Tartu, Estonia; Department of Surgery, University of Tartu, Tartu, Estonia
| | - P Kampus
- Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia; Endothelial Centre, University of Tartu, Tartu, Estonia; Department of Cardiology, University of Tartu, Tartu, Estonia
| | - M Zagura
- Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia; Endothelial Centre, University of Tartu, Tartu, Estonia
| | - J Eha
- Endothelial Centre, University of Tartu, Tartu, Estonia; Department of Cardiology, University of Tartu, Tartu, Estonia
| | - M Zilmer
- Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia; Endothelial Centre, University of Tartu, Tartu, Estonia
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Root MM, Houser SM, Anderson JJB, Dawson HR. Healthy Eating Index 2005 and selected macronutrients are correlated with improved lung function in humans. Nutr Res 2014; 34:277-84. [PMID: 24774063 DOI: 10.1016/j.nutres.2014.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 02/20/2014] [Accepted: 02/27/2014] [Indexed: 12/19/2022]
Abstract
A number of dietary components have been associated with lung function. However, a comprehensive measure of a healthy diet has not been compared with lung function. Herein, we test the hypothesis that a healthy overall diet, as assessed by the Healthy Eating Index 2005 (HEI-2005), will be associated with increased lung function. This is an investigation using the Atherosclerosis Risk in Communities Research Materials obtained from the National Heart Lung Blood Institute. The study surveyed dietary habits of 15 567 American subjects from 4 communities in 1987 to 1990. Spirometric measures of lung function were also taken at entry to the study and a second time 3 years later. Based on food and nutritional data collected by food frequency questionnaire, an HEI-2005 score was calculated for each subject. This total score, together with its 12 components scores and associated macronutrient, was compared with lung function results by linear regression. Models were controlled for smoking behavior, demographics, and other important covariates. The HEI-2005 total scores were positively associated with forced expiratory volume in 1 second per forced vital capacity (FEV(1)/FVC) at visit 1 (β = .101 per increase in 1 quintile of HEI-2005) and visit 2 (β = .140), and FEV(1) as percentage of the predicted FEV(1) at visit 2 (β = .215) (P < .05). In addition, HEI-2005 component scores that represented high intakes of whole grains (β = .127 and .096); saturated fats (β = -.091); and solid fats, alcohol, and added sugar (β = -.109 and -.131) were significantly associated with FEV(1)/FVC at either visit 1 or visit 2. Intakes of total calories (β =-.082 at visit 1) and saturated fatty acids (β = -.085 at visit 2) were negatively associated with FEV(1)/FVC. Dietary polyunsaturated fatty acids (β = .085 and .116) and long-chain omega-3 fatty acids (β = .109 and .103), animal protein (β = .132 and .093), and dietary fiber (β = .129) were positively associated with lung health. An overall healthy diet is associated with higher lung function.
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Affiliation(s)
- Martin M Root
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC.
| | - Shannon M Houser
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC
| | | | - Hannah R Dawson
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC
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