This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (15)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Cardiovascular System, Other  • Cardiovascular System  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic  Social Bookmarking   What's this?

Mahmoud Zureik, MD, PhD; Francine Kauffmann, MD; Pierre-Jean Touboul, MD; Dominique Courbon, BS; Pierre Ducimetière, PhD

Arch Intern Med. 2001;161:1669-1676.

Background  Numerous population-based studies have suggested that impaired lung function is associated with subsequent coronary heart diseases–related mortality and cardiovascular disease–related mortality. The relative contribution of atherosclerosis in these associations is unknown.

Objective  To examine the association of peak expiratory flow (PEF) with the occurrence during 4 years of atherosclerotic plaques in the extracranial carotid arteries in a sample of 656 subjects (aged 59-71 years) free of coronary heart disease and stroke at baseline.

Methods  Peak expiratory flow was measured at the baseline examination. Peak expiratory flow values relative to the predicted values (relative PEF values) were calculated, predicted values being obtained from previously published sex-specific regression equations of PEF on age and height. A carotid B-mode ultrasonographic examination was performed at baseline and 2 and 4 years later. The occurrence of carotid plaques during follow-up was defined as the appearance of 1 plaque (or more) in previously normal carotid segments and/or the appearance of new plaques in the carotid segments that previously had plaques.

Results  The proportion of subjects who experienced an occurrence of carotid atherosclerotic plaques during follow-up was 16.8% (110/656). The unadjusted odds ratios from the highest to the lowest quintiles of relative PEF values were 1.00, 1.07 (95% confidence interval [CI], 0.69-2.79), 1.08 (95% CI, 0.52-2.24), 1.38 (95% CI, 0.69-2.79), and 3.07 (95% CI, 1.62-5.85) (P<.001 for trend). Adjustment for major known cardiovascular risk factors did not markedly change the results, and the multivariate-adjusted odds ratio of carotid plaque occurrence in subjects with the lowest quintile of PEF compared with those with the highest quintile remained highly significant (odds ratio, 2.84; 95% CI, 1.45-5.71) (P = .002). Particularly in all smoking categories, carotid plaque occurrence was higher in subjects with the lowest relative PEF values. In never smokers, the multivariate-adjusted odds ratio of carotid plaque occurrence in subjects with the lowest quintile of PEF compared with those with the highest quintile was 2.80 (95% CI, 1.14-6.88).

Conclusions  Reduced lung function predicts the development of carotid atherosclerosis in elderly subjects. The nature of these associations remains largely unknown and merits further investigations. Nevertheless, assessment of lung function, which is simple and inexpensive, could help identify a population at high risk of atherosclerosis development and coronary heart disease.

From the Units of Cardiovascular and Metabolic Epidemiology (Drs Zureik and Ducimetière and Ms Courbon) and Epidemiology and Biostatistics (Dr Kauffmann), the National Institute of Health and Medical Research, Villejuif, and the Centre de Diagnostic et de Prévention Neurovasculaire Paris (Dr Touboul), France.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Sex-specific effect of body weight gain on systemic inflammation in subjects with COPD: results from the SAPALDIA cohort study 2
Bridevaux et al.
Eur Respir J 2009;34:332-339.
ABSTRACT | FULL TEXT  

Lung Function Impairment and Metabolic Syndrome: The Critical Role of Abdominal Obesity
Leone et al.
Am. J. Respir. Crit. Care Med. 2009;179:509-516.
ABSTRACT | FULL TEXT  

Airflow Limitation in Smokers Is Associated with Subclinical Atherosclerosis
Iwamoto et al.
Am. J. Respir. Crit. Care Med. 2009;179:35-40.
ABSTRACT | FULL TEXT  

Relationship between lung function impairment and incidence or recurrence of cardiovascular events in a middle-aged cohort
Johnston et al.
Thorax 2008;63:599-605.
ABSTRACT | FULL TEXT  

The Association Between Metabolic Syndrome and Restrictive Ventilatory Dysfunction in Older Persons
Fimognari et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2007;62:760-765.
ABSTRACT | FULL TEXT  

Cardiovascular Morbidity and Mortality in COPD
Huiart et al.
Chest 2005;128:2640-2646.
ABSTRACT | FULL TEXT  

Association of bronchial hyperresponsiveness and lung function with C-reactive protein (CRP): a population based study
Kony et al.
Thorax 2004;59:892-896.
ABSTRACT | FULL TEXT  

Bronchial Hyperresponsiveness to Methacholine Is Associated With Increased Common Carotid Intima-Media Thickness in Men
Zureik et al.
Arterioscler. Thromb. Vasc. Bio. 2004;24:1098-1103.
ABSTRACT | FULL TEXT  

Echogenic Carotid Plaques Are Associated With Aortic Arterial Stiffness in Subjects With Subclinical Carotid Atherosclerosis
Zureik et al.
Hypertension 2003;41:519-527.
ABSTRACT | FULL TEXT  

Rhinitis Is Associated with Increased Systolic Blood Pressure in Men: A Population-based Study
Kony et al.
Am. J. Respir. Crit. Care Med. 2003;167:538-543.
ABSTRACT | FULL TEXT  

Serum Elastase Activity, Serum Elastase Inhibitors, and Occurrence of Carotid Atherosclerotic Plaques: The Etude sur le Vieillissement Arteriel (EVA) Study
Zureik et al.
Circulation 2002;105:2638-2645.
ABSTRACT | FULL TEXT  

Reduced Pulmonary Function Is Associated with Central Arterial Stiffness in Men
ZUREIK et al.
Am. J. Respir. Crit. Care Med. 2001;164:2181-2185.
ABSTRACT | FULL TEXT