Department of Preventive Medicine and Environmental Health, College of Public Health, University of Kentucky, Lexington, Kentucky, USA.
Respirology. 2013 Oct;18(7):1083-8. doi: 10.1111/resp.12119.
We sought to determine the relationship between chronic respiratory disease, cardiovascular disease (CVD) and mortality in a nationally representative cohort of the US population aged 40 years and older.
We analysed data from the baseline (1988-1994) and follow-up of the Third National Health and Nutrition Examination Survey (NHANES III). Subjects were classified in to one of four categories: obstructed (forced expiratory volume in 1 s/forced vital capacity <70% and forced expiratory volume in 1 s <80% predicted), restricted (forced expiratory volume in 1 s/forced vital capacity ≥70% and forced vital capacity <80% predicted), symptomatic (neither obstructed nor restricted but reporting respiratory symptoms) and normal (none of the above). Subjects were classified as having overt CVD, CVD risk factors only or neither at the baseline examination.
The analysis data set included 9054 subjects, of whom 1132 (12.0%, weighted percentage (WP)) were obstructed, 1319 (10.3%, WP) were restricted and 2457 were symptomatic (27.6%, WP). Overt CVD was present at baseline in 1284 subjects (10.4 %, WP), and CVD risk factors alone were present in 4900 (53.3%, WP). Three thousand five hundred seventy-one (28.4%, WP) subjects died during the up to 18-year follow-up period. When compared with 'normal' subjects, those in the obstructed group were more likely to have overt CVD (odds ratio 1.87, 95% confidence interval: 1.15-3.04, P < 0.001), with a similar risk seen in the restricted and symptomatic group.
In this large US population-based cohort, the presence of obstruction, restriction or respiratory symptoms alone was associated with higher adjusted risk of overt CVD.
我们旨在确定美国 40 岁及以上人群中慢性呼吸道疾病、心血管疾病（CVD）与死亡率之间的关系。
我们分析了 1988-1994 年第三次全国健康和营养检查调查（NHANES III）基线和随访数据。受试者被分为以下四类：阻塞性（1 秒用力呼气量/用力肺活量<70%，且 1 秒用力呼气量<预计值的 80%）、限制性（1 秒用力呼气量/用力肺活量≥70%，且用力肺活量<预计值的 80%）、有症状性（既非阻塞性也非限制性，但有呼吸道症状）和正常（以上均无）。在基线检查时，受试者被分为有明显 CVD、仅有 CVD 危险因素或两者均无。
分析数据集包括 9054 名受试者，其中 1132 名（12.0%，加权百分比（WP））为阻塞性，1319 名（10.3%，WP）为限制性，2457 名有症状（27.6%，WP）。基线时存在明显 CVD 的受试者为 1284 名（10.4%，WP），仅有 CVD 危险因素的受试者为 4900 名（53.3%，WP）。在长达 18 年的随访期间，3571 名（28.4%，WP）受试者死亡。与“正常”受试者相比，阻塞组更有可能患有明显 CVD（优势比 1.87，95%置信区间：1.15-3.04，P<0.001），限制组和有症状组也有类似的风险。
在这项大型美国人群队列研究中，单独存在阻塞、限制或呼吸道症状与明显 CVD 的调整后风险增加相关。
