Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA.
Division of Pulmonary and Critical Care Medicine, University of California, Irvine, CA, USA.
Respir Med. 2017 Oct;131:85-93. doi: 10.1016/j.rmed.2017.08.001. Epub 2017 Aug 2.
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the U.S. There is a strong association between COPD and cardiovascular (CV) disease; however, the relation between COPD and CV health factors is not well defined. We examined the relation between lung function and CV health factors defined by American Heart Association's (AHA) Life's Simple 7 (LS7).
We studied 6352 adults aged ≥20 from the National Health and Nutrition Examination Survey (NHANES) 2009-2012. Analysis of variance was used to compare mean FEV1% of predicted across levels of each LS7 metric and population attributable risk was calculated based on COPD prevalence. We also conducted linear regression and logistic regression analyses to determine the association between lung function, COPD and LS7 score.
Overall 19.9% of subjects were defined as having COPD. Subjects in the highest categories of the LS7 metrics had the highest mean values of FEV1% of predicted (p < 0.0001 except for total cholesterol). Current smoking and hypertension had a population attributed risk of 21.8% and 21.1% of COPD, respectively. Compared to subjects with 0 ideal health factors, the gender and ethnicity-adjusted odds (95% CI) for COPD were 0.45 (0.22-0.93), 0.22 (0.11-0.43) for those with 4 and 5-7 factors, but adjustment for age attenuated this relation.
LS7 score is associated with lung function as well as the odds of COPD that is largely explained by age. Studies are needed to show if promotion of CV health will preserve healthy lung function.
慢性阻塞性肺疾病（COPD）是美国第三大致死原因。COPD 与心血管（CV）疾病之间存在很强的关联；然而，COPD 与 CV 健康因素之间的关系尚未明确。我们研究了肺功能与美国心脏协会（AHA）生命的 7 个简单指标（LS7）定义的 CV 健康因素之间的关系。
我们研究了来自国家健康和营养调查（NHANES）2009-2012 年的 6352 名年龄≥20 岁的成年人。方差分析用于比较每个 LS7 指标水平的预计 FEV1%的平均值，并根据 COPD 的患病率计算人群归因风险。我们还进行了线性回归和逻辑回归分析，以确定肺功能、COPD 和 LS7 评分之间的关系。
总体而言，19.9%的受试者被定义为患有 COPD。LS7 指标最高类别的受试者的预计 FEV1%的平均值最高（p<0.0001，除总胆固醇外）。当前吸烟和高血压分别导致 COPD 的人群归因风险为 21.8%和 21.1%。与没有 0 个理想健康因素的受试者相比，调整性别和种族后的 COPD 发生的比值比（95%置信区间）分别为 0.45（0.22-0.93）和 0.22（0.11-0.43），而调整年龄则减弱了这种关系。
LS7 评分与肺功能以及 COPD 的几率相关，而 COPD 的几率在很大程度上可以通过年龄来解释。需要进行研究以确定促进 CV 健康是否会保持健康的肺功能。
