Excess risk of major vascular diseases associated with airflow obstruction: a 9-year prospective study of 0.5 million Chinese adults

Om P Kurmi; Liming Li; Kourtney J Davis; Jenny Wang; Derrick A Bennett; Ka Hung Chan; Ling Yang; Yiping Chen; Yu Guo; Zheng Bian; Junshi Chen; Liuping Wei; Donghui Jin; Rory Collins; Richard Peto; Zhengming Chen

doi:10.2147/COPD.S153641

Excess risk of major vascular diseases associated with airflow obstruction: a 9-year prospective study of 0.5 million Chinese adults

Om P Kurmi, Liming Li, Kourtney J Davis, Jenny Wang, Derrick A Bennett, Ka Hung Chan, Ling Yang, Yiping Chen, Yu Guo, Zheng Bian, Junshi Chen, Liuping Wei, Donghui Jin, Rory Collins, Richard Peto, Zhengming Chen

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Abstract

Background: China has high COPD rates, even among never-regular smokers. Little is known about nonrespiratory disease risks, especially vascular morbidity and mortality after developing airflow obstruction (AFO) in Chinese adults.

Objective: We aimed to investigate the prospective association of prevalent AFO with major vascular morbidity and mortality.

Materials and methods: In 2004-2008, a nationwide prospective cohort study recruited 512,891 men and women aged 30-79 years from 10 diverse localities across China, tracking cause-specific mortality and coded episodes of hospitalization for 9 years. Cox regression yielded adjusted HRs for vascular diseases comparing individuals with spirometry-defined prevalent AFO at baseline to those without.

Results: Of 489,382 participants with no vascular disease at baseline, 6.8% had AFO, with prevalence rising steeply with age. Individuals with prevalent AFO had significantly increased vascular mortality (n=1,429, adjusted HR 1.29, 95% CI 1.21-1.36). There were also increased risks of hemorrhagic stroke (n=823, HR 1.18, 95% CI 1.09-1.27), major coronary events (n=635, HR 1.33, 95% CI 1.22-1.45), and heart failure (n=543, HR 2.19, 95% CI 1.98-2.41). For each outcome, the risk increased progressively with increasing COPD severity and persisted among never-regular smokers.

Conclusion: Among adult Chinese, AFO was associated with significantly increased risks of major vascular morbidity and mortality. COPD management should be integrated with vascular disease prevention and treatment programs to improve long-term prognosis.

Original language	English
Pages (from-to)	855-865
Number of pages	11
Journal	International Journal of Chronic Obstructive Pulmonary Disease
Volume	13
DOIs	https://doi.org/10.2147/COPD.S153641
Publication status	Published - 8 Mar 2018
Externally published	Yes

Bibliographical note

This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords

Adult
Aged
Airway Obstruction/diagnosis
Cardiovascular Diseases/diagnosis
Chi-Square Distribution
China/epidemiology
Comorbidity
Forced Expiratory Volume
Humans
Lung/physiopathology
Middle Aged
Prevalence
Prognosis
Proportional Hazards Models
Prospective Studies
Pulmonary Disease, Chronic Obstructive/diagnosis
Risk Assessment
Risk Factors
Smoking/adverse effects
Spirometry
Time Factors
Vital Capacity

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2147/COPD.S153641Licence: CC BY

PublishedFinal published version, 879 KBLicence: CC BY

Cite this

Kurmi, O. P., Li, L., Davis, K. J., Wang, J., Bennett, D. A., Chan, K. H., Yang, L., Chen, Y., Guo, Y., Bian, Z., Chen, J., Wei, L., Jin, D., Collins, R., Peto, R., & Chen, Z. (2018). Excess risk of major vascular diseases associated with airflow obstruction: a 9-year prospective study of 0.5 million Chinese adults. International Journal of Chronic Obstructive Pulmonary Disease, 13, 855-865. https://doi.org/10.2147/COPD.S153641

Kurmi, OP, Li, L, Davis, KJ, Wang, J, Bennett, DA, Chan, KH, Yang, L, Chen, Y, Guo, Y, Bian, Z, Chen, J, Wei, L, Jin, D, Collins, R, Peto, R & Chen, Z 2018, 'Excess risk of major vascular diseases associated with airflow obstruction: a 9-year prospective study of 0.5 million Chinese adults', International Journal of Chronic Obstructive Pulmonary Disease, vol. 13, pp. 855-865. https://doi.org/10.2147/COPD.S153641

@article{82296f350d344c8a8b6c49dbba0dce47,

title = "Excess risk of major vascular diseases associated with airflow obstruction: a 9-year prospective study of 0.5 million Chinese adults",

abstract = "Background: China has high COPD rates, even among never-regular smokers. Little is known about nonrespiratory disease risks, especially vascular morbidity and mortality after developing airflow obstruction (AFO) in Chinese adults.Objective: We aimed to investigate the prospective association of prevalent AFO with major vascular morbidity and mortality.Materials and methods: In 2004-2008, a nationwide prospective cohort study recruited 512,891 men and women aged 30-79 years from 10 diverse localities across China, tracking cause-specific mortality and coded episodes of hospitalization for 9 years. Cox regression yielded adjusted HRs for vascular diseases comparing individuals with spirometry-defined prevalent AFO at baseline to those without.Results: Of 489,382 participants with no vascular disease at baseline, 6.8% had AFO, with prevalence rising steeply with age. Individuals with prevalent AFO had significantly increased vascular mortality (n=1,429, adjusted HR 1.29, 95% CI 1.21-1.36). There were also increased risks of hemorrhagic stroke (n=823, HR 1.18, 95% CI 1.09-1.27), major coronary events (n=635, HR 1.33, 95% CI 1.22-1.45), and heart failure (n=543, HR 2.19, 95% CI 1.98-2.41). For each outcome, the risk increased progressively with increasing COPD severity and persisted among never-regular smokers.Conclusion: Among adult Chinese, AFO was associated with significantly increased risks of major vascular morbidity and mortality. COPD management should be integrated with vascular disease prevention and treatment programs to improve long-term prognosis.",

keywords = "Adult, Aged, Airway Obstruction/diagnosis, Cardiovascular Diseases/diagnosis, Chi-Square Distribution, China/epidemiology, Comorbidity, Forced Expiratory Volume, Humans, Lung/physiopathology, Middle Aged, Prevalence, Prognosis, Proportional Hazards Models, Prospective Studies, Pulmonary Disease, Chronic Obstructive/diagnosis, Risk Assessment, Risk Factors, Smoking/adverse effects, Spirometry, Time Factors, Vital Capacity",

author = "Kurmi, {Om P} and Liming Li and Davis, {Kourtney J} and Jenny Wang and Bennett, {Derrick A} and Chan, {Ka Hung} and Ling Yang and Yiping Chen and Yu Guo and Zheng Bian and Junshi Chen and Liuping Wei and Donghui Jin and Rory Collins and Richard Peto and Zhengming Chen",

note = " This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2018",

month = mar,

day = "8",

doi = "10.2147/COPD.S153641",

language = "English",

volume = "13",

pages = "855--865",

journal = "International Journal of Chronic Obstructive Pulmonary Disease",

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T1 - Excess risk of major vascular diseases associated with airflow obstruction

T2 - a 9-year prospective study of 0.5 million Chinese adults

AU - Kurmi, Om P

AU - Li, Liming

AU - Davis, Kourtney J

AU - Wang, Jenny

AU - Bennett, Derrick A

AU - Chan, Ka Hung

AU - Yang, Ling

AU - Chen, Yiping

AU - Guo, Yu

AU - Bian, Zheng

AU - Chen, Junshi

AU - Wei, Liuping

AU - Jin, Donghui

AU - Collins, Rory

AU - Peto, Richard

AU - Chen, Zhengming

N1 - This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2018/3/8

Y1 - 2018/3/8

N2 - Background: China has high COPD rates, even among never-regular smokers. Little is known about nonrespiratory disease risks, especially vascular morbidity and mortality after developing airflow obstruction (AFO) in Chinese adults.Objective: We aimed to investigate the prospective association of prevalent AFO with major vascular morbidity and mortality.Materials and methods: In 2004-2008, a nationwide prospective cohort study recruited 512,891 men and women aged 30-79 years from 10 diverse localities across China, tracking cause-specific mortality and coded episodes of hospitalization for 9 years. Cox regression yielded adjusted HRs for vascular diseases comparing individuals with spirometry-defined prevalent AFO at baseline to those without.Results: Of 489,382 participants with no vascular disease at baseline, 6.8% had AFO, with prevalence rising steeply with age. Individuals with prevalent AFO had significantly increased vascular mortality (n=1,429, adjusted HR 1.29, 95% CI 1.21-1.36). There were also increased risks of hemorrhagic stroke (n=823, HR 1.18, 95% CI 1.09-1.27), major coronary events (n=635, HR 1.33, 95% CI 1.22-1.45), and heart failure (n=543, HR 2.19, 95% CI 1.98-2.41). For each outcome, the risk increased progressively with increasing COPD severity and persisted among never-regular smokers.Conclusion: Among adult Chinese, AFO was associated with significantly increased risks of major vascular morbidity and mortality. COPD management should be integrated with vascular disease prevention and treatment programs to improve long-term prognosis.

AB - Background: China has high COPD rates, even among never-regular smokers. Little is known about nonrespiratory disease risks, especially vascular morbidity and mortality after developing airflow obstruction (AFO) in Chinese adults.Objective: We aimed to investigate the prospective association of prevalent AFO with major vascular morbidity and mortality.Materials and methods: In 2004-2008, a nationwide prospective cohort study recruited 512,891 men and women aged 30-79 years from 10 diverse localities across China, tracking cause-specific mortality and coded episodes of hospitalization for 9 years. Cox regression yielded adjusted HRs for vascular diseases comparing individuals with spirometry-defined prevalent AFO at baseline to those without.Results: Of 489,382 participants with no vascular disease at baseline, 6.8% had AFO, with prevalence rising steeply with age. Individuals with prevalent AFO had significantly increased vascular mortality (n=1,429, adjusted HR 1.29, 95% CI 1.21-1.36). There were also increased risks of hemorrhagic stroke (n=823, HR 1.18, 95% CI 1.09-1.27), major coronary events (n=635, HR 1.33, 95% CI 1.22-1.45), and heart failure (n=543, HR 2.19, 95% CI 1.98-2.41). For each outcome, the risk increased progressively with increasing COPD severity and persisted among never-regular smokers.Conclusion: Among adult Chinese, AFO was associated with significantly increased risks of major vascular morbidity and mortality. COPD management should be integrated with vascular disease prevention and treatment programs to improve long-term prognosis.

KW - Adult

KW - Aged

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KW - Cardiovascular Diseases/diagnosis

KW - Chi-Square Distribution

KW - China/epidemiology

KW - Comorbidity

KW - Forced Expiratory Volume

KW - Humans

KW - Lung/physiopathology

KW - Middle Aged

KW - Prevalence

KW - Prognosis

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Pulmonary Disease, Chronic Obstructive/diagnosis

KW - Risk Assessment

KW - Risk Factors

KW - Smoking/adverse effects

KW - Spirometry

KW - Time Factors

KW - Vital Capacity

U2 - 10.2147/COPD.S153641

DO - 10.2147/COPD.S153641

M3 - Article

C2 - 29563785

SN - 1176-9106

VL - 13

SP - 855

EP - 865

JO - International Journal of Chronic Obstructive Pulmonary Disease

JF - International Journal of Chronic Obstructive Pulmonary Disease

ER -

Excess risk of major vascular diseases associated with airflow obstruction: a 9-year prospective study of 0.5 million Chinese adults

Abstract

Bibliographical note

Keywords

UN SDGs

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