Abstract
Background
This study aimed to investigate associations between lung function and cardiovascular risk in a general population sample of men and women aged 45.
Methods
Data from the Dunedin Multidisciplinary Health and Development Study, an ongoing long-running cohort of 1037 children born in Dunedin, New Zealand between 1972-1973, was used. We studied 863 of the surviving cohort (n=997) that underwent assessment at age 45. Lung function determined by spirometry, body plethysmography, gas diffusion tests, and airway conductance were the main predictors. Log-transformed cardiovascular risk scores determined using two multivariable cardiovascular risk algorithms, i.e., PREDICT and Framingham Risk Score (FRS), were used as the dependent variables. The association was investigated cross-sectionally at age 45 and longitudinally using changes in lung function between ages 32-45 as the predictor. Analyses were adjusted for height and then body mass index (BMI) and cumulative smoking exposure. Separate analyses were conducted for never smokers. Interaction term testing was performed to assess effect modification by sex or current asthma.
Results
Cross sectionally, several measures of low lung function were associated with a greater cardiovascular risk score (both log-PREDICT and log-FRS). This association was stronger in women than in men, was independent of smoking history, and was present in never smokers, even after adjusting for BMI. Associations were found between measures of lung volumes (FEV1, FVC, VA, TLC, and FRC) but not for measures of airway function (FEV1/FVC ratio and sGaw) or gas transfer (DLco/VA). Similar findings were observed during the longitudinal analyses between changes in lung function between 32-45 and cardiovascular risk score at age 45.
Conclusions
Low pulmonary function (specifically lung volumes) at age 45 and accelerated pulmonary function decline between ages 32-45 are associated with a higher estimated cardiovascular risk score. This association is stronger in women, is independent of smoking and body mass index, and is present in never smokers.