The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature

Chest. 2005 Jun;127(6):1952-9. doi: 10.1378/chest.127.6.1952.


Study objectives: Conditions that give rise to reduced lung function are frequently associated with low-grade systemic inflammation, which may lead to poor cardiovascular outcomes. We sought to determine the relationship between reduced FEV1 and cardiovascular mortality, independent of smoking.

Design: Longitudinal population-based study and a meta-analysis of literature.

Setting: Representative sample of the general population.

Participants: Participants of the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study who were 40 to 60 years of age at baseline assessment (n = 1,861).

Measurements and results: We compared the risk of cardiovascular mortality across quintiles of FEV1. Individuals in the lowest FEV1 quintile had the highest risk of cardiovascular mortality (relative risk [RR], 3.36; 95% confidence interval [CI], 1.54 to 7.34). Compared to FEV1 quintile 1, individuals in quintile 5 had a fivefold increase in the risk of death from ischemic heart disease (RR, 5.65; 95% CI, 2.26 to 14.13). We also performed a systematic review of large cohort studies (> 500 participants) that reported on the relationship between FEV1 and cardiovascular mortality (12 studies; n = 83,880 participants). Compared to participants in the highest FEV1 category, those with reduced FEV1 had a higher risk of cardiovascular mortality (pooled RR, 1.77; 95% CI, 1.56 to 1.97).

Conclusions: There is strong epidemiologic evidence to indicate that reduced FEV1 is a marker for cardiovascular mortality independent of age, gender, and smoking history.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Age Distribution
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / therapy
  • Cause of Death*
  • Cohort Studies
  • Comorbidity
  • Confidence Intervals
  • Female
  • Humans
  • Longitudinal Studies
  • Lung Diseases / diagnosis
  • Lung Diseases / epidemiology*
  • Male
  • Middle Aged
  • Probability
  • Proportional Hazards Models
  • Respiratory Function Tests*
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Spirometry
  • Survival Analysis