• Siew-Mooi Ching, Yook-Chin Chia, LentjesMarleen A HMAHDepartment of Public Health and Primary Care, Institute of Public Health, School of Clinical Medicine (K-TK and RL) and the Medical Research Council Epidemiology Unit (NW), University of Cambridge, Cambridge, United Kingdom., Robert Luben, Nicholas Wareham, and Kay-Tee Khaw.
• Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia. sm_ching@upm.edu.my.
• Bmc Public Health. 2019 May 3; 19 (1): 501.

BackgroundOur study aimed to determine the association between forced expiratory volume in one second (FEV1) and subsequent fatal and non-fatal events in a general population.MethodsThe Norfolk (UK) based European Prospective Investigation into Cancer (EPIC-Norfolk) recruited 25,639 participants between 1993 and 1997. FEV1 measured by portable spirometry, was categorized into sex-specific quintiles. Mortality and morbidity from all causes, cardiovascular disease (CVD) and respiratory disease were collected from 1997 up to 2015. Cox proportional hazard regression analysis was used with adjustment for socio-economic factors, physical activity and co-morbidities.ResultsMean age of the population was 58.7 ± 9.3 years, mean FEV1 for men was 294± 74 cL/s and 214± 52 cL/s for women. The adjusted hazard ratios for all-cause mortality for participants in the highest fifth of the FEV1 category was 0.63 (0.52, 0.76) for men and 0.62 (0.51, 0.76) for women compared to the lowest quintile. Adjusted HRs for every 70 cL/s increase in FEV1 among men and women were 0.77 (p < 0.001) and 0.68 (p < 0.001) for total mortality, 0.85 (p<0.001) and 0.77 (p<0.001) for CVD and 0.52 (p <0.001) and 0.42 (p <0.001) for respiratory disease.ConclusionsParticipants with higher FEV1 levels had a lower risk of CVD and all-cause mortality. Measuring the FEV1 with a portable handheld spirometry measurement may be used as a surrogate marker for cardiovascular risk. Every effort should be made to identify those with poorer lung function even in the absence of cardiovascular disease as they are at greater risk of total and CV mortality.

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