RT Journal Article
SR Electronic
T1 The association between lung function and fatal stroke in a community followed for 4 decades
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP 1030
OP 1036
DO 10.1136/jech-2011-200312
VO 66
IS 11
A1 Gulsvik, Anne Kristine
A1 Gulsvik, Amund
A1 Skovlund, Eva
A1 Thelle, Dag Steinar
A1 Mowé, Morten
A1 Humerfelt, Sjur
A1 Wyller, Torgeir Bruun
YR 2012
UL http://jech.bmj.com/content/66/11/1030.abstract
AB Background Previous studies, all of <20 years of follow-up, have suggested an association between lung function and the risk of fatal stroke. This study investigates the stability of this association in a cohort followed for 4 decades. Methods The Bergen Clinical Blood Pressure Survey was conducted in Norway in 1964–1971. The risk of fatal stroke associated with forced expiratory volume after one second (FEV1) was estimated with Cox proportional hazards regression, making progressive adjustment for potential confounders. Results Of 5617 (84%) participants with recorded baseline FEV1, 462 died from stroke over 152 786 subsequent person-years of follow-up according to mortality statistics of 2005; mean (SD) follow-up was 27 (12) years. An association between baseline FEV1 (L) and fatal stroke was observed; HR=1.38 (95% CI 1.11 to 1.71) and HR=1.62 (95% CI 1.22 to 2.15) for men and women, respectively (adjusted for age and height). The findings were not explained by smoking, hypertension, diabetes, atherosclerosis, socioeconomic status, obstructive lung disease, physical inactivity, cholesterol or body mass index and persisted in subgroups of never-smokers, subgroups without respiratory symptoms and survivors of the first 20 years of follow-up. For male survivors with a valid FEV1 at follow-up (1988–1990) (n=953), baseline FEV1 (L) indicated a possible strong and independent association to the risk of fatal stroke after adjustments for individual changes in FEV1 (ml/year) (HR 1.95 (95% CI 0.98 to 3.86)). Conclusion There is a consistent, independent and long-lasting association between lung function and fatal stroke, probably irrespective of changes during adult life.