Lung function, inflammation and cardiovascular mortality in Africans

Background The link between impaired lung function and cardiovascular outcome is well established in European and American populations. It is possible that this association may be driven by a systemic spillover of inflammation occurring within the lungs. As several studies have found an increased le...

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Veröffentlicht in:European journal of clinical investigation Jg. 46; H. 11; S. 901 - 910
Hauptverfasser: Breet, Yolandi, Schutte, Aletta E., Huisman, Hugo W., Eloff, Fritz C., Du Plessis, Johan L., Kruger, Annamarie, Van Rooyen, Johannes M.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Blackwell Publishing Ltd 01.11.2016
Schlagworte:
Adult
African
African Continental Ancestry Group - ethnology
Aged
Cardiovascular diseases
Cardiovascular Diseases - ethnology
Cardiovascular Diseases - mortality
Cardiovascular Diseases - physiopathology
death
Epidemiology
Female
Forced Expiratory Volume - physiology
Health risk assessment
Humans
Inflammation
Interleukins
Kaplan-Meier Estimate
Lungs
Male
Markers
Middle Aged
Mortality
Pneumonia - ethnology
Pneumonia - mortality
Pneumonia - physiopathology
Populations
Prospective Studies
pulmonary function
Regression analysis
Regression models
Respiratory function
Rural Health - statistics & numerical data
South Africa
South Africa - epidemiology
South Africa - ethnology
Urban Health - statistics & numerical data
Vital Capacity - physiology
pulmonary function
South Africa
death
African
ISSN:0014-2972, 1365-2362
Online-Zugang:Volltext
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Zusammenfassung:Background The link between impaired lung function and cardiovascular outcome is well established in European and American populations. It is possible that this association may be driven by a systemic spillover of inflammation occurring within the lungs. As several studies have found an increased level of inflammatory markers in African populations, we aimed to establish the contribution of lung function in predicting all‐cause and cardiovascular mortality in Africans, whilst taking inflammatory markers into account. Design We followed 1442 black South Africans from the North West Province participating in the South African leg of the Prospective Urban and Rural Epidemiology (PURE) study, over a five‐year period. Spirometry, cardiovascular and metabolic measures were performed, and cardiovascular mortality as well as all‐cause mortality used as endpoints. Results In univariate Cox regression models, both forced expiratory volume in 1‐s (FEV1) and forced vital capacity (FVC) predicted all‐cause (P = 0·022; P < 0·001) and cardiovascular mortality (P = 0·004; P < 0·001). In multivariate adjusted standardized Cox regression analyses, only FVC predicted cardiovascular mortality independent of several covariates (hazard ratio, 0·57 [0·35–0·94]), including C‐reactive protein (CRP). When CRP was replaced by interleukin‐6 in the model, the significance of FVC was lost (hazard ratio, 0·85 [0·55–1·30]). Conclusion FVC, but not FEV1, is a strong predictor of both all‐cause and CV mortality in black South Africans, which may be mediated by inflammation.
Bibliographie:South African National Research Foundation - No. 2069139; No. FA2006040700010
ArticleID:ECI12674
North-West University
ark:/67375/WNG-51RQGQ5K-H
Table S1. Standardized Cox proportional hazard ratios of either FEV1 or FVC with all-cause and cardiovascular mortality.
Roche Diagnostics South Africa
South Africa Netherlands Research Programme on Alternatives in Development
Population Health Research Institute
South African Medical Research Council
istex:B2C9264F00917738157E0880556B9FD8AC16BFB2
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SourceType-Scholarly Journals-1
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ISSN:0014-2972
1365-2362
DOI:10.1111/eci.12674