Background
Methods
Participants
Data collection
FEV1 measurement
Anthropometric, lifestyle and socio-economic measurements
Outcome
Outcome ascertainment
Follow-up
Statistical analysis
Results
Clinical variables | Unit | Respiratory function FEV1 category (cL/s) | P* | ||||
---|---|---|---|---|---|---|---|
Quintile | <229 | 229 to <272 | 272 to < 309 | 309 to < 353 | ≥ 353 | ||
Men (%, n) | 100, 10168 | 18.3, 1857 | 19.3, 1959 | 20.5, 2087 | 20.6, 2097 | 21.3, 2168 | |
Mean respiratory function FEV1 (cL/s) | 293.7±73.9 | 184.1± 39.6 | 252.0±12.1 | 291.2±10.9 | 330.7±12.7 | 392.0±31.5 | <0.001 |
Mean age (year) | 58.9±9.3 | 66.0± 7.9 | 62.9±8.5 | 59.3±8.5 | 56.0±7.8 | 51.9±6.2 | <0.001 |
Mean Height (cm) | 174.2±6.7 | 170.7±6.5 | 1712.0±6.2 | 173.7±6.1 | 175.5±6.0 | 178.3±5.8 | <0.001 |
Mean systolic BP (mm Hg) | 137.2±17.5 | 142.8± 19.0 | 140.8±17.7 | 137.5±17.8 | 134.9±15.8 | 131.1±14.9 | <0.001 |
Mean alcohol (units/week) | 10.4±11.9 | 9.4± 11.9 | 10.1±12.2 | 9.9±11.5 | 11.0±12.1 | 11.5±11.6 | 0.411 |
Mean BMI (kg/m2) | 26.5±3.3 | 26.8± 3.7 | 27.0±3.3 | 26.5±3.3 | 26.3±3.1 | 26.0±3.1 | <0.001 |
Mean plasma vitamin C (umol/l) | 47.4±18.7 | 42.7± 20.0 | 45.3±18.2 | 47.9±18.6 | 49.1±17.6 | 51.0±18.2 | <0.001 |
Mean serum cholesterol (mmol/L) | 6.0±1.1 | 6.1±1.1 | 6.1±1.1 | 6.1±1.0 | 6.1±1.1 | 5.9±1.1 | 0.897 |
Physically inactive [% (n)] | 29.3(2982) | 43.7 (812) | 33.2(650) | 27.4(571) | 24.1(506) | 20.4(443) | <0.001 |
Manual social class [% (n)] | 41.6(4160) | 48.3 (870) | 45.6(877) | 42.8(877) | 38.9(805) | 34.1(731) | <0.001 |
No educational qualification [% (n)] | 29.5(3001) | 44.2 (819) | 34.6(678) | 29.7(620) | 24.9(521) | 16.8(363) | <0.001 |
Current smokers [% (n)] | 12.5(1261) | 17.7 (327) | 12.8(249) | 13.2(273) | 11.6(242) | 7.9(170) | <0.001 |
History of diabetes [% (n)] | 2.7 (271) | 4.0 (74) | 4.0(79) | 2.6(54) | 2.1(45) | 0.9(19) | <0.001 |
History of asthma [% (n)] | 7.7(787) | 17.1 (318) | 7.9(154) | 6.2(129) | 4.9 (102) | 3.9(84) | <0.001 |
History of bronchitis [% (n)] | 8.7(886) | 16.2 (300) | 8.1(159) | 6.9(143) | 6.7(140) | 6.6(144) | <0.001 |
Clinical variables | Unit | Respiratory function FEV1 category (cL/s) | P* | ||||
Quintile | <170 | 170 to <200 | 200 to < 227 | 227 to < 257 | ≥ 257 | ||
Women (%, n) | 100, 12494 | 19.6, 2449 | 19.3, 2413 | 20.2, 2528 | 20.4, 2555 | 20.4, 2549 | |
Mean respiratory function FEV1(cL/s) | 214.4±52.0 | 139.9 ± 26.6 | 186.3±8.7 | 213.9±7.8 | 241.7±8.5 | 285.4±23.0 | <0.001 |
Mean age (year) | 58.5±9.3 | 66.1± 7.7 | 62.6±8.5 | 58.4±8.3 | 54.8±7.4 | 51.2±6.1 | <0.001 |
Mean Height (cm) | 161.0±6.2 | 157.6±6.0 | 159.2±5.5 | 160.8±5.5 | 162.2±5.5 | 165.1±5.5 | <0.001 |
Mean systolic BP(mm Hg) | 133.6±18.8 | 142.5± 19.9 | 137.9±19.3 | 133.3±17.4 | 129.5±16.9 | 125.4±15.6 | <0.001 |
Mean alcohol (units/week) | 4.5±5.7 | 3.7±5.3 | 3.9±5.1 | 4.5±5.8 | 4.9±5.9 | 5.5±6.1 | <0.001 |
Mean BMI (kg/m2) | 26.2±4.3 | 26.9±4.5 | 26.8±4.6 | 26.3±4.3 | 25.9±4.2 | 25.1±3.8 | <0.001 |
Mean vitamin C (umol/l) | 58.6±19.9 | 54.5±21.0 | 57.6±20.3 | 58.8±19.9 | 59.9±19.6 | 61.8±17.8 | <0.001 |
Mean cholesterol (mmol/L) | 6.3±1.2 | 6.7±1.2 | 6.5±1.2 | 6.4±1.2 | 6.2±1.2 | 5.8±1.1 | <0.001 |
Physical inactive [% (n)] | 29.5(3687) | 46.3 (1134) | 36.1 (871) | 26.3 (664) | 22.2 (568) | 17.7 (450) | 0.005 |
Manual social class [% (n)] | 38.9(4738) | 44.8 (1045) | 42.6 (997) | 39.7 (977) | 35.6 (893) | 32.7 (826) | <0.001 |
No educational qualification [% (n)] | 41.7(5205) | 58.0 (1419) | 49.9 (1204) | 42.9 (1083) | 34.6 (885) | 24.1 (614) | <0.001 |
Current smokers [% (n)] | 11.5(1426) | 14.1 (341) | 12.0 (286) | 11.0 (275) | 11.3 (287) | 9.3 (237) | <0.001 |
History of diabetes [% (n)] | 1.4(180) | 2.2 (55) | 2.1(50) | 1.5 (38) | 0.9 (23) | 0.5 (14) | <0.001 |
History of asthma [% (n)] | 9.0(1120) | 16.5 (404) | 8.7(209) | 7.7 (194) | 6.4 (164) | 5.8 (149) | <0.001 |
History of bronchitis [% (n)] | 9.5(1190) | 13.9. (340) | 9.4 (226) | 8.6 (217) | 8.3 (212) | 7.7 (195) | <0.001 |
Respiratory function FEV1 category (cL/s) | |||||||
---|---|---|---|---|---|---|---|
Quintile | <229 | 229 to <272 | 272 to < 309 | 309 to < 353 | ≥ 353 |
HR(95% CI) per 70 cL/s increase
| P-linear trend |
Men | |||||||
Deaths: all causes % (n) | 35.8 (1108) | 25.7 (794) | 18.7 (579) | 12.7 (394) | 7.1 (221) | <0.001 | |
HR (95% CI) a | 1 | 0.69(0.63,0.75) | 0.60(0.54,0.66) | 0.55(0.49,0.62) | 0.48(0.41,0.56) | 0.72(0.69,0.75) | <0.001 |
HR (95% CI) b | 1 | 0.74(0.67,0.82) | 0.69(0.61.77) | 0.66(0.58,0.76) | 0.63(0.52,0.76) | 0.77(0.73,0.81) | <0.001 |
Deaths from cardiovascular causes % (n) | 37.5 (359) | 29.2 (279) | 16.3 (156) | 12.1 (116) | 4.9 (47) | <0.001 | |
HR (95% CI) a | 1 | 0.77(0.66,0.9) | 0.54(0.44,0.65) | 0.57(0.46,0.72) | 0.39(0.28,0.54) | 0.70(0.65,0.76) | <0.001 |
HR (95% CI) b | 1 | 0.89(0.75,1.06) | 0.67(0.54,0.84) | 0.75(0.58,0.97) | 0.64(0.44,0.92) | 0.80(0.73,0.88) | <0.001 |
Deaths from myocardial infarction causes % (n) | 35.1 (191) | 29.5 (161) | 15.2 (83) | 14.1 (77) | 6.1 (33) | <0.001 | |
HR (95% CI) a | 1 | 0.84(0.68,1.04) | 0.54(0.41,0.70) | 0.71(0.53,0.94) | 0.50(0.33,0.75) | 0.75(0.68,0.83) | <0.001 |
HR (95% CI) b | 1 | 0.99(0.78,1.26) | 0.70(0.52,0.94) | 0.97(0.70,1.35) | 0.90(0.57,1.42) | 0.88(0.78,1.00) | 0.05 |
Deaths from stroke causes % (n) | 33.7 ( 68) | 31.7 (64) | 19.8 (40) | 12.3 (25) | 2.5 (5) | <0.001 | |
HR (95% CI) a | 1 | 0.91(0.65,1.28) | 0.72(0.48,1.08) | 0.66(0.41,1.08) | 0.24(0.09,0.61) | 0.73(0.62,0.86) | 0.027 |
HR (95% CI) b | 1 | 0.97(0.66,1.42) | 0.78(0.49,1.23) | 0.78(0.45,1.37) | 0.38(0.14,1.04) | 0.78(0.64,0.95) | 0.015 |
Deaths from respiratory disease causes %(n) | 62.4 (184) | 17.6 (52) | 12.5 (37) | 5.1 (15) | 2.4 (7) | <0.001 | |
HR (95% CI) a | 1 | 0.27(0.20,0.37) | 0.24(0.17,0.35) | 0.14(0.08,0.25) | 0.12(0.05,0.26) | 0.32(0.28,0.36) | <0.001 |
HR (95% CI) b | 1 | 0.33(0.23,0.46) | 0.29(0.19,0.43) | 0.20(0.11,0.35) | 0.19(0.08,0.43) | 0.35(0.30,0.41) | <0.001 |
Cardiovascular disease events %(n) | 28.5 (1028) | 23.9 (863) | 21.1 (760) | 15.9 (576) | 10.6 (384) | <0.001 | |
HR (95% CI) a | 1 | 0.78(0.71,0.85) | 0.73(0.66,0.80) | 0.64(0.57,0.71) | 0.51(0.45,0.58) | 0.80(0.77,0.83) | <0.001 |
HR (95% CI) b | 1 | 0.82(0.74,0.91) | 0.81(0.72,0.90) | 0.73(0.64,0.82) | 0.63(0.54,0.73) | 0.85(0.81,0.89) | <0.001 |
Myocardial infarction events % (n) | 30.6(528) | 25.0(431) | 19.7 (340) | 15.9 (275) | 8.8 (152) | <0.001 | |
HR (95% CI) a | 1 | 0.78(0.69,0.89) | 0.66(0.58,0.76) | 0.63(0.54,0.74) | 0.42(0.34,0.51) | 0.77(0.73,0.81) | <0.001 |
HR (95% CI) b | 1 | 0.85(0.74,0.98) | 0.78(0.67,0.91) | 0.79(0.66,0.95) | 0.58(0.46,0.73) | 0.85(0.79,0.91) | 0.001 |
Stroke events % (n) | 34.7 (157) | 28.0 (127) | 16.8 (76) | 12.8 (58) | 7.7 (35) | <0.001 | |
HR (95% CI) a | 1 | 0.86(0.68,1.08) | 0.62(0.47,0.82) | 0.66(0.48,0.92) | 0.64(0.43,0.97) | 0.79(0.71,0.88) | 0.008 |
HR (95% CI) b | 1 | 0.98(0.75.1.28) | 0.78(0.57,1.08) | 0.86(0.59,1.26) | 0.99(0.96,1.02) | 0.90(0.79,1.03) | 0.13 |
Respiratory disease events %(n) | 41.3 (669) | 22.0 (357) | 16.7 (271) | 11.5 (186) | 8.5 (138) | <0.001 | |
HR (95% CI) a | 1 | 0.46(0.40,0.52) | 0.34(0.29,0.39) | 0.25(0.21,0.30) | 0.21(0.17,0.26) | 0.51(0.48,0.54) | <0.001 |
HR (95% CI) b | 1 | 0.48(0.41,0.55) | 0.37(0.32,0.44) | 0.28(0.23,0.33) | 0.26(0.18,0.28) | 0.52(0.49,0.55) | <0.001 |
Respiratory function FEV1 category (cL/s) | |||||||
Quintile | <170 | 170 to <200 | 200 to < 227 | 227 to < 257 | ≥ 257 |
HR(95%CI) per 70 cL/s increase
| P-linear trend |
Women | |||||||
Deaths: all causes % (n),2758 | 42.1 (1161) | 25.0 (688) | 16.6 (459) | 9.6 (266) | 6.7 (184) | <0.001 | |
HR (95% CI) a | 1 | 0.68(0.63,0.75) | 0.62(0.55,0.69) | 0.51(0.44,0.59) | 0.55(0.46,0.66) | 0.65(0.61,0.69) | <0.001 |
HR (95% CI) b | 1 | 0.71(0.64,0.80) | 0.65(0.57,0.74) | 0.57(0.48,0.67) | 0.62(0.51,0.76) | 0.68(0.63,0.74) | <0.001 |
Deaths from cardiovascular causes % (n) | 47.1(376) | 27.7 (221) | 16.5 (132) | 5.9 (47) | 2.8 (22) | <0.001 | |
HR (95% CI) a | 1 | 0.73(0.61,0.86) | 0.67(0.55,0.82) | 0.39(0.29,0.54) | 0.35(0.22,0.55) | 0.65(0.57,0.73) | <0.001 |
HR (95% CI) b | 1 | 0.76(0.63,0.92) | 0.73(0.57,0.92) | 0.50(0.36,0.71) | 0.40(0.24,0.67) | 0.67(0.58,0.78) | <0.001 |
Deaths from myocardial infarction causes %(n) | 48.3 (146) | 27.2 (82) | 16.9 (51) | 5.6 (17) | 2.0(6) | <0.001 | |
HR (95% CI) a | 1 | 0.69(0.52,0.89) | 0.63(0.45,0.88) | 0.33(0.20,0.56) | 0.21(0.09,0.49) | 0.56(0.46,0.67) | <0.001 |
HR (95% CI) b | 1 | 0.77(0.57,1.04) | 0.67(0.45,0.99) | 0.46(0.26,0.81) | 0.27(0.10,0.72) | 0.60(0.47,0.75) | <0.001 |
Deaths from stroke causes %(n) | 43.5 (133) | 30.4 (93) | 16.7 (51) | 6.5 (20) | 2.9 (9) | <0.001 | |
HR (95% CI) a | 1 | 0.88(0.68,1.15) | 0.79(0.57,1.11) | 0.54(0.33,0.89) | 0.51(0.25,1.04) | 0.81(0.67,0.99) | 0.08 |
HR (95% CI) b | 1 | 0.89(0.65,1.21) | 0.86(0.59,1.27) | 0.66(0.39,1.13) | 0.55(0.25,1.21) | 0.85(0.67,1.08) | 0.18 |
Deaths from respiratory disease causes %(n) | 61.1 (149) | 20.9(51) | 11.0 (27) | 4.9 (12) | 2.1 (5) | <0.001 | |
HR (95% CI) a | 1 | 0.39(0.28,0.54) | 0.29(0.19,0.44) | 0.19(0.10,0.35) | 0.13(0.05,0.33) | 0.28(0.23,0.35) | <0.001 |
HR (95% CI) b | 1 | 0.43(0.30,0.62) | 0.39(0.25,0.62) | 0.26(0.13,0.51) | 0.24(0.09,0.63) | 0.35(0.27,0.44) | <0.001 |
Cardiovascular disease events %(n) | 33.8 (1206) | 25.9 (924) | 18.6 (664) | 12.6 (446) | 9.1 (325) | <0.001 | |
HR (95% CI) a | 1 | 0.83(0.76,0.91) | 0.68(0.62,0.75) | 0.54(0.48,0.61) | 0.50(0.43,0.57) | 0.72(0.68,0.76) | <0.001 |
HR (95% CI) b | 1 | 0.85(0.77,0.94) | 0.75(0.67,0.84) | 0.64(0.56,0.73) | 0.58(0.49,0.68) | 0.77(0.72,0.83) | <0.001 |
Myocardial infarction events %(n) | 39.7 (429) | 26.9(291) | 17.8 (192) | 8.8 (95) | 6.8 (74) | <0.001 | |
HR (95% CI) a | 1 | 0.79(0.68,0.92) | 0.67(0.56,0.80) | 0.43(0.34,0.54) | 0.47(0.35,0.62) | 0.69(0.63,0.76) | <0.001 |
HR (95% CI) b | 1 | 0.79(0.67,0.94) | 0.70(0.57,0.85) | 0.48(0.37,0.63) | 0.59(0.43,0.81) | 0.74(0.66,0.83) | <0.001 |
Stroke events %(n) | 46.7 (233) | 25.9 (129) | 15.4 (77) | 7.4 (37) | 4.6 (23) | <0.001 | |
HR (95% CI) a | 1 | 0.69(0.56,0.86) | 0.62(0.47,0.81) | 0.46(0.31,0.66) | 0.47(0.29,0.76) | 0.71(0.61,0.82) | <0.001 |
HR (95% CI) b | 1 | 0.68(0.53,0.88) | 0.67(0.49,0.91) | 0.51(0.34,0.77) | 0.48(0.28,0.83) | 0.74(0.62,0.89) | 0.001 |
Respiratory disease events %(n) | 40.3 (665) | 23.1 (382) | 16.2 (268) | 11.9 (196) | 8.5 (141) | <0.001 | |
HR (95% CI) a | 1 | 0.55(0.41,0.63) | 0.39(0.38,0.46) | 0.30(0.25,0.36) | 0.23(0.19,0.28) | 0.43(0.40,0.47) | <0.001 |
HR (95% CI) b | 1 | 0.54(0.47,0.62) | 0.40(0.34,0.47) | 0.29(0.24,0.36) | 0.21(0.16,0.26) | 0.42(0.38,0.46) | <0.001 |
Number/ Total |
HR (95%CI) per 70 cL/s increase in FEV1
a
|
P
|
HR (95%CI) per 70 cL/s increase in FEV1
b
|
P
| |
---|---|---|---|---|---|
All | 4734/19139 | 0.71(0.68, 0.73) | <0.001 | 0.74(0.71, 0.77) | <0.001 |
Gender | |||||
Men | 2572/8719 | 0.72(0.69, 0.76) | <0.001 | 0.77(0.73, 0.81) | <0.001 |
Women | 2162/8258 | 0.67(0.62, 0.72) | <0.001 | 0.68(0.63, 0.74) | <0.001 |
Age | |||||
<65 | 1661/13631 | 0.74(0.70, 0.78) | <0.001 | 0.79(0.74, 0.84) | <0.001 |
≥65 | 3073/5508 | 0.67(0.65, 0.71) | <0.001 | 0.70(0.67, 0.74) | <0.001 |
Excluding early deaths < 5 years | 4196/18601 | 0.72(0.69, 0.75) | <0.001 | 0.76(0.72, 0.79) | <0.001 |
Smoking status | |||||
-Current smokers | 670/ 2214 | 0.72(0.65, 0.80) | <0.001 | 0.71(0.63, 0.79) | <0.001 |
-Ex-smokers | 2344/7955 | 0.71(0.67, 0.75) | <0.001 | 0.72(0.68, 0.76) | <0.001 |
-Never smokers | 1720/8970 | 0.81(0.75, 0.87) | <0.001 | 0.82(0.76, 0.89) | <0.001 |
By BMI | |||||
<27 kg/m2 | 2759/12146 | 0.69(0.66, 0.73) | <0.001 | 0.73(0.69, 0.77) | <0.001 |
≥27 kg/m2 | 1975/6993 | 0.72(0.69, 0.78) | <0.001 | 0.75(0.71, 0.81) | <0.001 |
By physical activity | |||||
- Inactive | 1977/5467 | 0.65(0.62, 0.69) | <0.001 | 0.68(0.64, 0.72) | <0.001 |
- Active | 2757/13672 | 0.76(0.72, 0.80) | <0.001 | 0.79(0.75, 0.84) | <0.001 |
Excluding asthma or bronchitis | 4772/17837 | 0.72(0.69, 0.75) | <0.001 | 0.76(0.73, 0.79) | <0.001 |
Social class | |||||
-Nonmanual social class | 2737/11509 | 0.73(0.69, 0.77) | <0.001 | 0.75(0.71, 0.80) | <0.001 |
-Manual social class | 1997/7630 | 0.69(0.65, 0.73) | <0.001 | 0.72(0.68, 0.77) | <0.001 |
Plasma Vitamin C | |||||
-Less than median | 2646/9206 | 0.71(0.67, 0.75) | <0.001 | 0.73(0.69, 0.77) | <0.001 |
-more than median | 2088/9933 | 0.74(0.69, 0.78) | <0.001 | 0.75(0.71, 0.80) | <0.001 |