Impact of lung-function measures on cardiovascular disease events in older adults with metabolic syndrome and diabetes

Hwa Mu Lee, Yanglu Zhao, Michael A. Liu, Norbert Yanez, Mercedes Carnethon, R. Graham Barr, Nathan D. Wong

Research output: Contribution to journalArticle

Abstract

Background: Individuals with metabolic syndrome (MetS) and diabetes (DM) are more likely to have decreased lung function and are at greater risk of cardiovascular disease (CVD). Hypothesis.: Lung-function measures can predict CVD events in older persons with MetS, DM, and neither condition. Methods: We followed 4114 participants age ≥ 65 years with and without MetS or DM in the Cardiovascular Health Study. Cox regression examined the association of forced vital capacity (FVC) and 1-second forced expiratory volume (FEV1; percent of predicted values) with incident coronary heart disease and CVD events over 12.9 years. Results: DM was present in 537 (13.1%) and MetS in 1277 (31.0%) participants. Comparing fourth vs first quartiles for FVC, risk of CVD events was 16% (HR: 0.84, 95% CI: 0.59–1.18), 23% (HR: 0.77, 95% CI: 0.60–0.99), and 30% (HR: 0.70, 95% CI: 0.58–0.84) lower in DM, MetS, and neither disease groups, respectively. For FEV1, CVD risk was lower by 2% (HR: 0.98, 95% CI: 0.70–1.37), 26% (HR: 0.74, 95% CI: 0.59–0.93), and 31% (HR: 0.69, 95% CI: 0.57–0.82) in DM. Findings were strongest for predicting congestive heart failure (CHF) in all disease groups. C-statistics increased significantly with addition of FEV1 or FVC over risk factors for CVD and CHF among those with neither MetS nor DM. Conclusions: FEV1 and FVC are inversely related to CVD in older adults with and without MetS, but not DM (except for CHF); however, their value in incremental risk prediction beyond standard risk factors is limited mainly to metabolically healthier persons.

Original languageEnglish (US)
Pages (from-to)959-965
Number of pages7
JournalClinical Cardiology
Volume41
Issue number7
DOIs
StatePublished - Jul 1 2018
Externally publishedYes

Fingerprint

Cardiovascular Diseases
Vital Capacity
Lung
Heart Failure
Forced Expiratory Volume
Coronary Disease
Health

Keywords

  • Cardiovascular
  • Cox Regression
  • Diabetes
  • Lung Function
  • Metabolic Syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of lung-function measures on cardiovascular disease events in older adults with metabolic syndrome and diabetes. / Lee, Hwa Mu; Zhao, Yanglu; Liu, Michael A.; Yanez, Norbert; Carnethon, Mercedes; Graham Barr, R.; Wong, Nathan D.

In: Clinical Cardiology, Vol. 41, No. 7, 01.07.2018, p. 959-965.

Research output: Contribution to journalArticle

Lee, Hwa Mu ; Zhao, Yanglu ; Liu, Michael A. ; Yanez, Norbert ; Carnethon, Mercedes ; Graham Barr, R. ; Wong, Nathan D. / Impact of lung-function measures on cardiovascular disease events in older adults with metabolic syndrome and diabetes. In: Clinical Cardiology. 2018 ; Vol. 41, No. 7. pp. 959-965.
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T1 - Impact of lung-function measures on cardiovascular disease events in older adults with metabolic syndrome and diabetes

AU - Lee, Hwa Mu

AU - Zhao, Yanglu

AU - Liu, Michael A.

AU - Yanez, Norbert

AU - Carnethon, Mercedes

AU - Graham Barr, R.

AU - Wong, Nathan D.

PY - 2018/7/1

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N2 - Background: Individuals with metabolic syndrome (MetS) and diabetes (DM) are more likely to have decreased lung function and are at greater risk of cardiovascular disease (CVD). Hypothesis.: Lung-function measures can predict CVD events in older persons with MetS, DM, and neither condition. Methods: We followed 4114 participants age ≥ 65 years with and without MetS or DM in the Cardiovascular Health Study. Cox regression examined the association of forced vital capacity (FVC) and 1-second forced expiratory volume (FEV1; percent of predicted values) with incident coronary heart disease and CVD events over 12.9 years. Results: DM was present in 537 (13.1%) and MetS in 1277 (31.0%) participants. Comparing fourth vs first quartiles for FVC, risk of CVD events was 16% (HR: 0.84, 95% CI: 0.59–1.18), 23% (HR: 0.77, 95% CI: 0.60–0.99), and 30% (HR: 0.70, 95% CI: 0.58–0.84) lower in DM, MetS, and neither disease groups, respectively. For FEV1, CVD risk was lower by 2% (HR: 0.98, 95% CI: 0.70–1.37), 26% (HR: 0.74, 95% CI: 0.59–0.93), and 31% (HR: 0.69, 95% CI: 0.57–0.82) in DM. Findings were strongest for predicting congestive heart failure (CHF) in all disease groups. C-statistics increased significantly with addition of FEV1 or FVC over risk factors for CVD and CHF among those with neither MetS nor DM. Conclusions: FEV1 and FVC are inversely related to CVD in older adults with and without MetS, but not DM (except for CHF); however, their value in incremental risk prediction beyond standard risk factors is limited mainly to metabolically healthier persons.

AB - Background: Individuals with metabolic syndrome (MetS) and diabetes (DM) are more likely to have decreased lung function and are at greater risk of cardiovascular disease (CVD). Hypothesis.: Lung-function measures can predict CVD events in older persons with MetS, DM, and neither condition. Methods: We followed 4114 participants age ≥ 65 years with and without MetS or DM in the Cardiovascular Health Study. Cox regression examined the association of forced vital capacity (FVC) and 1-second forced expiratory volume (FEV1; percent of predicted values) with incident coronary heart disease and CVD events over 12.9 years. Results: DM was present in 537 (13.1%) and MetS in 1277 (31.0%) participants. Comparing fourth vs first quartiles for FVC, risk of CVD events was 16% (HR: 0.84, 95% CI: 0.59–1.18), 23% (HR: 0.77, 95% CI: 0.60–0.99), and 30% (HR: 0.70, 95% CI: 0.58–0.84) lower in DM, MetS, and neither disease groups, respectively. For FEV1, CVD risk was lower by 2% (HR: 0.98, 95% CI: 0.70–1.37), 26% (HR: 0.74, 95% CI: 0.59–0.93), and 31% (HR: 0.69, 95% CI: 0.57–0.82) in DM. Findings were strongest for predicting congestive heart failure (CHF) in all disease groups. C-statistics increased significantly with addition of FEV1 or FVC over risk factors for CVD and CHF among those with neither MetS nor DM. Conclusions: FEV1 and FVC are inversely related to CVD in older adults with and without MetS, but not DM (except for CHF); however, their value in incremental risk prediction beyond standard risk factors is limited mainly to metabolically healthier persons.

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