Yasuhiko Kubota1, Aaron R Folsom2, Kunihiro Matsushita3, David Couper4, Weihong Tang2. 1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA. Electronic address: kubot007@umn.edu. 2. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA. 3. Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 4. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
Abstract
BACKGROUND AND AIMS: No prospective study has investigated whether individuals with respiratory impairments, including chronic obstructive pulmonary disease (COPD) and restrictive lung disease (RLD), are at increased risk of abdominal aortic aneurysm (AAA). We aimed to prospectively investigate whether those respiratory impairments are associated with increased AAA risk. METHODS: In 1987-1989, the Atherosclerosis Risk in Communities (ARIC) study followed 14,269 participants aged 45-64 years, without a history of AAA surgery, through 2011. Participants were classified into four groups, "COPD" [forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <lower limit of normal (LLN)], "RLD" (FEV1/FVC ≥ LLN and FVC < LLN), "respiratory symptoms with normal spirometry" (without RLD or COPD), and "normal" (without respiratory symptoms, RLD or COPD, reference group). RESULTS: During the 284,969 person-years of follow-up, 534 incident AAA events were documented. In an age, sex, and race-adjusted proportional hazards model, individuals with respiratory impairments had a significantly higher risk of AAA than the normal reference group. After adjustment for AAA risk factors, including smoking status and pack-years of smoking, AAA risk was no longer significant in the respiratory symptoms with normal spirometry group [HR (95% CI), 1.25 (0.98-1.60)], but was still increased in the other two groups [RLD: 1.45 (1.04-2.02) and COPD: 1.66 (1.34-2.05)]. Moreover, continuous measures of FEV1/FVC, FEV1 and FVC were associated inversely with risk of AAA. CONCLUSIONS: In the prospective population-based cohort study, obstructive and restrictive spirometric patterns were associated with increased risk of AAA independent of smoking, suggesting that COPD and RLD may increase the risk of AAA.
BACKGROUND AND AIMS: No prospective study has investigated whether individuals with respiratory impairments, including chronic obstructive pulmonary disease (COPD) and restrictive lung disease (RLD), are at increased risk of abdominal aortic aneurysm (AAA). We aimed to prospectively investigate whether those respiratory impairments are associated with increased AAA risk. METHODS: In 1987-1989, the Atherosclerosis Risk in Communities (ARIC) study followed 14,269 participants aged 45-64 years, without a history of AAA surgery, through 2011. Participants were classified into four groups, "COPD" [forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <lower limit of normal (LLN)], "RLD" (FEV1/FVC ≥ LLN and FVC < LLN), "respiratory symptoms with normal spirometry" (without RLD or COPD), and "normal" (without respiratory symptoms, RLD or COPD, reference group). RESULTS: During the 284,969 person-years of follow-up, 534 incident AAA events were documented. In an age, sex, and race-adjusted proportional hazards model, individuals with respiratory impairments had a significantly higher risk of AAA than the normal reference group. After adjustment for AAA risk factors, including smoking status and pack-years of smoking, AAA risk was no longer significant in the respiratory symptoms with normal spirometry group [HR (95% CI), 1.25 (0.98-1.60)], but was still increased in the other two groups [RLD: 1.45 (1.04-2.02) and COPD: 1.66 (1.34-2.05)]. Moreover, continuous measures of FEV1/FVC, FEV1 and FVC were associated inversely with risk of AAA. CONCLUSIONS: In the prospective population-based cohort study, obstructive and restrictive spirometric patterns were associated with increased risk of AAA independent of smoking, suggesting that COPD and RLD may increase the risk of AAA.
Authors: Miguel Divo; Claudia Cote; Juan P de Torres; Ciro Casanova; Jose M Marin; Victor Pinto-Plata; Javier Zulueta; Carlos Cabrera; Jorge Zagaceta; Gary Hunninghake; Bartolome Celli Journal: Am J Respir Crit Care Med Date: 2012-05-03 Impact factor: 21.405
Authors: Kana Fujikura; Alessandra Albini; R Graham Barr; Megha Parikh; Julia Kern; Eric Hoffman; Grant T Hiura; David A Bluemke; James Carr; João A C Lima; Erin D Michos; Antoinette S Gomes; Martin R Prince Journal: Int J Cardiol Date: 2021-02-13 Impact factor: 4.164