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IJE Advance Access originally published online on February 8, 2009
International Journal of Epidemiology 2009 38(3):867-876; doi:10.1093/ije/dyn374
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Lung function in mid-life compared with later life is a stronger predictor of arterial stiffness in men: The Caerphilly Prospective Study

Charlotte E Bolton1,*, John R Cockcroft2, Ramsey Sabit1, Margaret Munnery1, Carmel M McEniery3, Ian B Wilkinson3, Shah Ebrahim4, John E Gallacher5, Dennis J Shale1 and Yoav Ben-Shlomo6

1 Department of Respiratory Medicine, School of Medicine, Cardiff University, Cardiff, South Wales, UK.
2 Wales Heart Research Institue, School of Medicine, Cardiff University, Cardiff, South Wales, UK.
3 Department of Clinical Pharmacology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
4 London School of Hygiene and Tropical Medicine, University of London, London, UK.
5 Department of Epidemiology, Statistics and Public Health, Centre for Health Sciences Research, Cardiff University, Cardiff, UK.
6 Department of Social Medicine, University of Bristol, Bristol, UK.

* Corresponding author. Department of Respiratory Medicine, School of Medicine, Cardiff University, Academic Centre, Llandough Hospital, Penlan Road, Cardiff CF64 2XX, South Wales, UK. E-mail: boltonce{at}cf.ac.uk


   Abstract

Background Increased arterial stiffness predicts future cardiovascular disease and in some cross-sectional studies it is related to worse lung function and obstructive pulmonary disease. We assessed the predictive value of lung function measured in mid-life as compared with later life on arterial stiffness in the Caerphilly Prospective Study (CaPS).

Methods Men aged 47–67 years had lung function measured between 1984 and 1988 and repeated between 2002 and 2004 (n = 827) as well as having carotid-femoral pulse wave velocity (PWV) measured.

Results Both forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in mid-life and later life were inversely associated with PWV (P < 0.0001) but mid-life measures were stronger predictors. Only mid-life measures remained predictors after mutual adjustment (FEV1 mid-life β coeff. –0.65, 95% CI –1.04, –0.26, P < 0.0001; FVC mid-life β coeff. –0.52, 95% CI –0.82, –0.23, P < 0.0001). Adjustment for smoking status, early life, inflammatory and metabolic factors in sub-groups did not markedly change the associations.

Conclusions Mid-life lung function is a stronger risk factor than in later life for arterial stiffness in men. It is possible that developmental factors influence both lung function and arterial stiffness. Lung function assessment in mid-life may identify individuals at greater risk of their future cardiovascular disease.


Keywords Epidemiology, cardiovascular disease, lung function, arterial stiffness

Accepted 18 December 2008


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