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Clinical Investigations: PULMONARY FUNCTION |

Pulmonary Function Is a Long-term Predictor of Mortality in the General Population*: 29-Year Follow-up of the Buffalo Health Study

Holger J. Schünemann, MD, PhD; Joan Dorn, PhD; Brydon J. B. Grant, MD, FCCP; Warren Winkelstein, Jr., MD, MPH; Maurizio Trevisan, MD, MS
Author and Funding Information

*From the Department of Social and Preventive Medicine (Drs. Schünemann, Dorn, and Trevisan), Pulmonary and Critical Care Division (Dr. Grant), Department of Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; and the Division of Population Biology and Epidemiology (Dr. Winkelstein), School of Public Health, University of California at Berkeley, Berkeley, CA.

Correspondence to: Holger J. Schünemann, MD, PhD, Departments of Medicine and Social and Preventive Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 270 Farber Hall, 3435 Main St, Buffalo, NY 14214-3000; e-mail: HJS@Buffalo.edu



Chest. 2000;118(3):656-664. doi:10.1378/chest.118.3.656
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Study objectives: Results from several studies have described a relationship between pulmonary function and both all-cause and cause-specific mortality. The purpose of this study was to investigate the predictive value of pulmonary function by gender after 29 years of follow-up.

Design: Prospective study with 29-year follow-up of the Buffalo Health Study cohort.

Participants: Randomly selected sample of 554 men and 641 women, aged 20 to 89 years, from all listed households of the city of Buffalo, NY.

Measurements and results: Baseline measurements were performed in 1960 to 1961. Pulmonary function was assessed based on FEV1 expressed as the normal percent predicted (FEV1%pred). FEV1%pred adjusted by age, body mass index, systolic BP, education, and smoking status was inversely related to all-cause mortality in both men and women (p < 0.01). A sequential survival analysis in participants who had a survival time of at least 5, 10, 15, 20, and 25 years after enrollment in the study was also performed. Except for men who survived for > 25 years, we observed a statistically significant negative association between FEV1%pred and all-cause mortality. FEV1%pred was also inversely related to ischemic heart disease (IHD) mortality. When participants were divided into quintiles of FEV1%pred, participants in the lowest quintile of FEV1%pred experienced significantly higher all-cause mortality compared with participants in the highest quintile of FEV1%pred. For the entire follow-up period, the adjusted hazard ratios for all-cause mortality were 2.24 (95% confidence interval [CI], 1.60 to 3.13) for men and 1.81 (95% CI, 1.24 to 2.63) for women, respectively. Hazard ratios for death from IHD in the lowest quintile of FEV1%pred were 2.11 (95% CI, 1.20 to 3.71) and 1.96 (95% CI, 0.99 to 3.88) for men and women, respectively.

Conclusions: These results suggest that pulmonary function is a long-term predictor for overall survival rates in both genders and could be used as a tool in general health assessment.


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