Research group, Clinical Epidemiology and Health Services in Stroke, Center for Stroke Research, Charité-Universitätsmedizin Berlin, Charitèplatz 1, 10117, Berlin, Germany.
Research group, Clinical Epidemiology and Health Services in Stroke, Center for Stroke Research, Charité-Universitätsmedizin Berlin, Charitèplatz 1, 10117, Berlin, Germany.
Arch Cardiovasc Dis. 2018 Apr;111(4):246-256. doi: 10.1016/j.acvd.2017.07.001. Epub 2017 Nov 4.
Pulmonary dysfunction and cardiovascular disease are major causes of impaired health status in later life, and co-development of these diseases has been reported.
To better understand the pathobiology involved in the co-development of these diseases.
We investigated the impact of pulmonary dysfunction on the development of cardiovascular disease among people aged≥50 years in the English longitudinal study of ageing (ELSA). Hazard ratios were estimated by Cox proportional hazards regression models, with and without a time-dependent update of exposure and confounders. Pulmonary function was divided into three categories, with the least affected category as the reference.
People with pulmonary dysfunction were at higher risk of developing cardiovascular disease than those with normal pulmonary function: the hazard ratio for pulmonary dysfunction versus healthy in the time-dependent crude analysis of model 1, adjusted for age, body mass index, sex, angina pectoris and heart arrhythmia, was 1.49 (95% confidence interval 1.2-1.9). The effect varied with the precise definition of pulmonary dysfunction and the subtype of the cardiovascular disease, and decreased after correction for some additional confounders but not after correction for inflammatory biomarkers.
A history of pulmonary disease increased the risk of developing cardiovascular disease, but inflammation did not seem to alter the effect of pulmonary dysfunction on cardiovascular disease development. This insight may lead to better understanding and treatment of cardiovascular comorbidities in pulmonary disease; it also indicates that the potentially beneficial effect of targeted anti-inflammatory drugs for pulmonary disease, in terms of reducing cardiovascular risk in these patients, may be limited.
肺部功能障碍和心血管疾病是导致晚年健康状况受损的主要原因，并且这两种疾病的发生存在共同发展的趋势。
为了更好地理解这两种疾病共同发展的病理生理学机制。
我们研究了肺部功能障碍对英国老龄化纵向研究（ELSA）中≥50 岁人群发生心血管疾病的影响。采用 Cox 比例风险回归模型，在不考虑和考虑暴露因素和混杂因素的时间依赖性更新的情况下，估计了风险比。将肺功能分为三个类别，以受影响最小的类别作为参照。
与肺功能正常的人相比，肺部功能障碍的人患心血管疾病的风险更高：在模型 1 的时间依赖性粗分析中，与健康人群相比，肺部功能障碍的风险比为 1.49（95%置信区间 1.2-1.9）。该效应因肺部功能障碍的精确定义和心血管疾病的亚型而异，在调整了一些其他混杂因素后有所下降，但在调整了炎症生物标志物后没有变化。
肺部疾病史增加了患心血管疾病的风险，但炎症似乎并没有改变肺部功能障碍对心血管疾病发展的影响。这一认识可能有助于更好地理解和治疗肺部疾病中的心血管合并症；这也表明，针对肺部疾病的靶向抗炎药物在降低这些患者的心血管风险方面的潜在有益效果可能有限。
