Predictors of loss of lung function in the elderly the cardiovascular health study
Predictors of loss of lung function in the elderly the cardiovascular health study
复制标题
DOI：
10.1164/ajrccm.163.1.9906089
复制
发表时间：
2001-01-01
影响因子：
24.7
通讯作者：
Enright, PL
中科院分区：
文献类型：
--
作者：
Griffith, KA;Sherrill, DL;Enright, PL
肺活量测定法（FEV1或FVC）测量的肺功能是老年人发病率和死亡率的重要独立预测指标。在这项研究中，我们检查了心血管健康研究（CHS）参与者肺功能纵向下降的预测因素。CHS始于1990年，是一项以人群为基础的老年人心血管疾病观察性研究。在基线、4年和7年后进行肺活量测定。采用随机效应模型（REM）对数据进行分析，其中包含AR(1)误差结构。5242名受试者（57.6%为女性，平均年龄73岁，87.5%为白人，12.5%为非洲裔美国人）符合FEV，占基线队列的89%。快速眼动实验结果显示，非裔美国人的肺活量明显低于白人，但随年龄增长肺活量下降的速度明显要慢得多。报告充血性心力衰竭（CHF）、高收缩压（> 160 mm Hg）或服用β受体阻滞剂的受试者肺活量测定水平显著降低；然而，高血压和服用-受体阻滞剂的影响随着年龄的增长而减弱。慢性支气管炎、肺炎、肺气肿和哮喘与肺活量测定值降低有关。这些分析中最值得注意的发现是，目前吸烟（尤其是男性）与FVC和FEV1的下降速度更快有关。非裔美国人（尤其是女性）的FEV1下降速度比白人慢。虽然目前患有哮喘的参与者在基线检查时的FEV1平均降低了0.5 L，但他们随后的FEV1下降速度并没有更快。
Pulmonary function, as measured by spirometry (FEV1 or FVC), is an important independent predictor of morbidity and mortality in elderly persons. In this study we examined the predictors of longitudinal decline in lung function for participants of the Cardiovascular Health Study (CHS). The CHS was started in 1990 as a population-based observational study of cardiovascular disease in elderly persons. Spirometry testing was conducted at baseline, 4 and 7 yr later. The data were analyzed using a random effects model (REM) including an AR(1) error structure. There were 5,242 subjects (57.6% female, mean age 73 yr, 87.5% white and 12.5% African-American) with eligible FEV, measures representing 89% of the baseline cohort. The REM results showed that African-Americans had significantly lower spirometry levels than whites but that their rate of decline with age was significantly less. Subjects reporting congestive heart failure (CHF), high systolic blood pressure (> 160 mm Hg), or taking beta-blockers had significantly lower spirometry levels; however, the effects of high blood pressure and taking beta-blockers diminished with increasing age. Chronic bronchitis, pneumonia, emphysema, and asthma were associated with reduced spirometry levels. The most notable finding of these analyses was that current smoking (especially for men) was associated with more rapid rates of decline in FVC and FEV1. African-Americans (especially women) had slower rates of decline in FEV1 than did whites. Although participants with current asthma had a mean 0.5 L lower FEV1 at their baseline examination, they did not subsequently experience more rapid declines in FEV1.