Peak flow rate and death due to coronary heart disease: 30-year results from the Northwick Park Heart cohort study.


Clayton, TC; Meade, TW; Turner, EL; De Stavola, BL; (2014) Peak flow rate and death due to coronary heart disease: 30-year results from the Northwick Park Heart cohort study. Open heart, 1 (1). e000164. ISSN 2053-3624 DOI: https://doi.org/10.1136/openhrt-2014-000164

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Abstract

OBJECTIVE Numerous studies have reported that chronic obstructive pulmonary disease or impaired lung function are associated with later coronary heart disease (CHD). However, it is unclear if lung function is an independent risk factor, as many of these studies have included only limited measures of other factors associated with CHD. METHODS In total 2167 men of all ages in the first Northwick Park Heart Study were followed for a median of 30 years. Cox regression models were used to assess the relationship between peak flow rate (PFR) and CHD mortality adjusted for potential confounders measured at baseline. Analyses allowed for missing data, and secondary analyses for repeat measures on some men and competing risks of CHD death. RESULTS There were 254 CHD deaths with some evidence of an association between PFR and CHD mortality. The adjusted HRs (95% CIs) from the lowest to the highest of four PFR quartiles were 1.53 (1.04 to 2.25), <430 L/min; 1.43 (0.99 to 2.08), 430 - <490 L/min; and 1.31 (0.93 to 1.86), 490 - <550 L/min; compared with the reference group of ≥550 L/min (trend test p=0.025). Other associations with CHD mortality were observed for systolic blood pressure (p<0.0001), body mass index (p=0.0002), smoking status (p=0.015), blood cholesterol (p=0.005), plasma fibrinogen (p=0.001) and high-risk ECG (p=0.021). There were no strong associations for factors V and VIII or platelet count. CONCLUSIONS After allowing for a range of other risk factors associated with CHD, there was only limited evidence of a relation between PFR and CHD mortality.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Medical Statistics
Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Centre for Statistical Methodology
PubMed ID: 25332831
URI: http://researchonline.lshtm.ac.uk/id/eprint/2006402

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