Published online before print October 14, 2002, doi: 10.1161/01.CIR.0000037220.00065.0D
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2002;106:2555.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Lung Function and Cardiovascular Risk
Relationship With Inflammation-Sensitive Plasma Proteins
From the Departments of Community Medicine (G.E., B.H., L.J.), Internal Medicine (P.L., L.S.), Vascular Diseases (F.L.), and Clinical Physiology (P.W.), Malmö University Hospital, Malmö, Sweden.
Correspondence to Gunnar Engström, Department of Community Medicine, Malmö University Hospital, S-20502 Malmö, Sweden. E-mail Gunnar.Engstrom{at}smi.mas.lu.se
Background— The inverse relationship between pulmonary function and incidence of cardiovascular disease remains largely unexplained. This prospective study explored the hypothesis of a relationship with inflammation-sensitive plasma proteins.
Methods and Results— Forced vital capacity (FVC) and plasma levels of fibrinogen, 
1-antitrypsin, haptoglobin, ceruloplasmin, and orosomucoid were determined in 5064 healthy men aged 28 to 61 years. All-cause mortality, cardiovascular mortality, and incidence of myocardial infarction were monitored over a mean follow-up period of 18.4 years. Low FVC (fourth quartile) was associated with higher protein levels and with increased incidences of myocardial infarction and cardiovascular death. Adjustments for protein levels reduced the age-adjusted relative risks (RRs) for myocardial infarction (from 1.99, 95% CI 1.5 to 2.6, to 1.70, 95% CI 1.3 to 2.2) and cardiovascular death (from 2.71, 95% CI 1.9 to 3.9, to 2.28, 95% CI 1.6 to 3.3) among men with low FVC, corresponding to 
25% of the excess risk. The risk factor–adjusted RRs were reduced from 1.45 (95% CI 1.1 to 1.9) to 1.38 (95% CI 1.1 to 1.8) and from 1.96 (95% CI 1.4 to 2.8) to 1.85 (95% CI 1.3 to 2.7) for myocardial infarction and cardiovascular death, respectively, corresponding to 10% to 15% of the excess risk. Among men with low FVC, the risk factor–adjusted RR for myocardial infarction was 2.5 (95% CI 1.7 to 3.6) for those with high protein levels (
2 proteins in top quartile) and 1.7 (95% CI 1.1 to 2.4) for those with low protein levels (
1 protein in top quartile; reference, top quartile of FVC and low protein levels).
Conclusions— FVC is significantly and inversely associated with plasma levels of inflammation-sensitive plasma proteins. This relationship contributes to but cannot fully explain the increased cardiovascular risk among men with low FVC.
Key Words: forced vital capacity • epidemiology • inflammation
This article has been cited by other articles:
 |
|
 |
|
  G. Engstrom, M. Gerhardsson de Verdier, M. Dahlback, C. Janson, and L. Lind BP Variability and Cardiovascular Autonomic Function in Relation to Forced Expiratory Volume: A Population-Based Study Chest, July 1, 2009; 136(1): 177 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. R. B. M. van Gestel, M. Chonchol, S. E. Hoeks, G. M. J. M. Welten, H. Stam, F. W. Mertens, R. T. van Domburg, and D. Poldermans Association between chronic obstructive pulmonary disease and chronic kidney disease in vascular surgery patients Nephrol. Dial. Transplant., April 15, 2009; (2009) gfp171v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G Engstrom, N Segelstorm, M Ekberg-Aronsson, P M Nilsson, F Lindgarde, and C-G Lofdahl Plasma markers of inflammation and incidence of hospitalisations for COPD: results from a population-based cohort study Thorax, March 1, 2009; 64(3): 211 - 215. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Rasmussen, D. Mikkelsen, R. J. Hancox, J. Lambrechtsen, M. Nybo, H. S. Hansen, and H. C. Siersted High-sensitive C-reactive protein is associated with reduced lung function in young adults Eur. Respir. J., February 1, 2009; 33(2): 382 - 388. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Sunyer, R. Pistelli, E. Plana, M. Andreani, F. Baldari, M. Kolz, W. Koenig, J. Pekkanen, A. Peters, and F. Forastiere Systemic inflammation, genetic susceptibility and lung function Eur. Respir. J., July 1, 2008; 32(1): 92 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Downs, C. Schindler, L.-J. S. Liu, D. Keidel, L. Bayer-Oglesby, M. H. Brutsche, M. W. Gerbase, R. Keller, N. Kunzli, P. Leuenberger, et al. Reduced Exposure to PM10 and Attenuated Age-Related Decline in Lung Function N. Engl. J. Med., December 6, 2007; 357(23): 2338 - 2347. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Bellia, C. Pedone, F. Catalano, A. Zito, E. Davi, S. Palange, F. Forastiere, and R. A. Incalzi Asthma in the Elderly: Mortality Rate and Associated Risk Factors for Mortality Chest, October 1, 2007; 132(4): 1175 - 1182. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. L. Fimognari, P. Pasqualetti, L. Moro, A. Franco, G. Piccirillo, R. Pastorelli, P. M. Rossini, and R. A. Incalzi The Association Between Metabolic Syndrome and Restrictive Ventilatory Dysfunction in Older Persons J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2007; 62(7): 760 - 765. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C-G. Lofdahl, D. S. Postma, N. B. Pride, J. Boe, and A. Thoren Possible protection by inhaled budesonide against ischaemic cardiac events in mild COPD Eur. Respir. J., June 1, 2007; 29(6): 1115 - 1119. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. G. Yanbaeva, M. A. Dentener, E. C. Creutzberg, G. Wesseling, and E. F. M. Wouters Systemic Effects of Smoking Chest, May 1, 2007; 131(5): 1557 - 1566. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S F P Man, J E Connett, N R Anthonisen, R A Wise, D P Tashkin, and D D Sin C-reactive protein and mortality in mild to moderate chronic obstructive pulmonary disease Thorax, October 1, 2006; 61(10): 849 - 853. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Aronson, I. Roterman, M. Yigla, A. Kerner, O. Avizohar, R. Sella, P. Bartha, Y. Levy, and W. Markiewicz Inverse Association between Pulmonary Function and C-Reactive Protein in Apparently Healthy Subjects Am. J. Respir. Crit. Care Med., September 15, 2006; 174(6): 626 - 632. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Tell and P. M. Nilsson Early ageing in middle-aged men is associated with adverse social factors and increased mortality risk: The Malmo Preventive Project Scand J Public Health, August 1, 2006; 34(4): 346 - 352. [Abstract] [PDF]
|
|
|
|
 |
|
 B. Thyagarajan, D. R Jacobs, G. G Apostol, L. J Smith, C. E Lewis, and O D. Williams Plasma fibrinogen and lung function: the CARDIA Study Int. J. Epidemiol., August 1, 2006; 35(4): 1001 - 1008. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 X. Guo, L. Pantoni, M. Simoni, D. Gustafson, C. Bengtsson, B. Palmertz, and I. Skoog Midlife Respiratory Function Related to White Matter Lesions and Lacunar Infarcts in Late Life: The Prospective Population Study of Women in Gothenburg, Sweden Stroke, July 1, 2006; 37(7): 1658 - 1662. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S Yende, G W Waterer, E A Tolley, A B Newman, D C Bauer, D R Taaffe, R Jensen, R Crapo, S Rubin, M Nevitt, et al. Inflammatory markers are associated with ventilatory limitation and muscle dysfunction in obstructive lung disease in well functioning elderly subjects Thorax, January 1, 2006; 61(1): 10 - 16. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F L Fimognari, L Moro, R Antonelli Incalzi, D D Sin, W Q Gan, S F P Man, and A Senthilselvan COPD, restrictive syndrome and inflammation Thorax, July 1, 2005; 60(7): 612 - 613. [Full Text] [PDF]
|
|
|
|
|
|
K. Stavem, E. Aaser, L. Sandvik, J. V. Bjornholt, G. Erikssen, E. Thaulow, and J. Erikssen Lung function, smoking and mortality in a 26-year follow-up of healthy middle-aged males Eur. Respir. J., April 1, 2005; 25(4): 618 - 625. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Calverley Are Inhaled Corticosteroids Systemic Therapy for Chronic Obstructive Pulmonary Disease? Am. J. Respir. Crit. Care Med., October 1, 2004; 170(7): 721 - 722. [Full Text] [PDF]
|
|
|
|
|
|
S Kony, M Zureik, F Driss, C Neukirch, B Leynaert, and F Neukirch Association of bronchial hyperresponsiveness and lung function with C-reactive protein (CRP): a population based study Thorax, October 1, 2004; 59(10): 892 - 896. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Nascimento, A. R. Qureshi, P. Stenvinkel, R. Pecoits-Filho, O. Heimburger, T. Cederholm, B. Lindholm, and P. Barany Malnutrition and inflammation are associated with impaired pulmonary function in patients with chronic kidney disease Nephrol. Dial. Transplant., July 1, 2004; 19(7): 1823 - 1828. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W Q Gan, S F P Man, A Senthilselvan, and D D Sin Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis Thorax, July 1, 2004; 59(7): 574 - 580. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Kaminsky Spirometry and Diabetes: Implications of reduced lung function Diabetes Care, March 1, 2004; 27(3): 837 - 838. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Lind, G. Engstrom, L. Stavenow, L. Janzon, F. Lindgarde, and B. Hedblad Risk of Myocardial Infarction and Stroke in Smokers Is Related to Plasma Levels of Inflammation-Sensitive Proteins Arterioscler. Thromb. Vasc. Biol., March 1, 2004; 24(3): 577 - 582. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. B. Schroeder, V. L. Welch, D. Couper, F. J. Nieto, D. Liao, W. D. Rosamond, and G. Heiss Lung Function and Incident Coronary Heart Disease: The Atherosclerosis Risk in Communities Study Am. J. Epidemiol., December 15, 2003; 158(12): 1171 - 1181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Engstrom, L. Stavenow, B. Hedblad, P. Lind, P. Tyden, L. Janzon, and F. Lindgarde Inflammation-Sensitive Plasma Proteins and Incidence of Myocardial Infarction in Men With Low Cardiovascular Risk Arterioscler. Thromb. Vasc. Biol., December 1, 2003; 23(12): 2247 - 2251. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Sin and S.F. P. Man Why Are Patients With Chronic Obstructive Pulmonary Disease at Increased Risk of Cardiovascular Diseases?: The Potential Role of Systemic Inflammation in Chronic Obstructive Pulmonary Disease Circulation, March 25, 2003; 107(11): 1514 - 1519. [Abstract] [Full Text] [PDF]
|
|