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Mortality and cardiovascular and respiratory morbidity in individuals with impaired FEV1 (PURE): an international, community-based cohort study

Duong M 1 , Islam S 2 , Rangarajan S 2 , Leong D 2 , Kurmi O 2 , Teo K 2 Show all authors , Killian K 2 , Dagenais G 3 , Lear S 4 , Wielgosz A 5 , Nair S 6 , Mohan V 7 , Mony P 8 , Gupta R 9 , Kumar R 10 , Rahman O 11 , Yusoff K 12 , du Plessis JL 13 , Igumbor EU 14 , Chifamba J 15 , Li W 16 , Lu Y 16 , Zhi F 16 , Yan R 16 , Iqbal R 17 , Ismail N 18 , Zatonska K 19 , Karsidag K 20 , Rosengren A 21 , Bahonar A 22 , Yusufali A 23 , Lamelas PM 24 , Avezum A 25 , Lopez-Jaramillo P 26 , Lanas F 27 , O'Byrne PM 2 , Yusuf S 2 , PURE investigators

Affiliations 

  • 1 Population Health Research Institute, Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; The Research Institute of St Joe's Hamilton, McMaster University, Hamilton, ON, Canada. Electronic address: duongmy@mcmaster.ca
  • 2 Population Health Research Institute, Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
  • 3 Université Laval, Institut Universitaire de Cardiologie et de Pneumologie de Québec, QC, Canada
  • 4 Faculty of Health Sciences and Department of Biomedical Physiology & Kinesiology, Simon Fraser University, Vancouver, BC, Canada
  • 5 Department of Medicine, University of Ottawa, Ottawa, ON, Canada
  • 6 Department of Pulmonary Medicine, Medical College, Thiruvananthapuram, Kerala, India; Health Action by People, Thiruvananthapuram, Kerala, India
  • 7 Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
  • 8 Community Health & Epidemiology, St John's Research Institute, Bangalore, Karnataka, India
  • 9 Eternal Heart Care Centre and Research Institute, Jaipur, Rajasthan, India
  • 10 Post Graduate Institute of Medical Education and Research (PGIMER), School of Public Health, Chandigarh, India
  • 11 Department of Community Medicine and School of Public Health, Independent University, Dhaka, Bangladesh
  • 12 Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia; University College Sedaya International (UCSI), Cheras, Kuala Lumpur, Malaysia
  • 13 Occupational Hygiene and Health Research Initiative, North-West University, Potchefstroom, North West Province, South Africa
  • 14 School of Public Health, University of the Western Cape, Cape Town, South Africa
  • 15 Physiology Department, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
  • 16 State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
  • 17 Department of Community Health Sciences and Medicine, Aga Khan University, Karachi, Sindh, Pakistan
  • 18 Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 19 Department of Social Medicine, Medical University of Wroclaw, Wroclaw, Poland
  • 20 Division of Endocrinology, Department of Internal Medicine, Medical Faculty of Istanbul University, Istanbul, Turkey
  • 21 Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Östra, Göteborg, Sweden
  • 22 Hypertension Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  • 23 Dubai Medical University, Hatta Hospital, Dubai Health Authority, Dubai, United Arab Emirates
  • 24 Estudios Clinicos Latinoamerica (ECLA), Rosario, Santa Fe, Argentina
  • 25 Dante Pazzanese Institute of Cardiology, São Paulo, São Paulo, Brazil
  • 26 Fundacion Oftalmologica de Santander (FOSCAL), Floridablanca, Santander, Colombia
  • 27 University of La Frontera, Temuco, Chile
Lancet Glob Health, 2019 05;7(5):e613-e623.
PMID: 31000131 DOI: 10.1016/S2214-109X(19)30070-1

Abstract

BACKGROUND: The associations between the extent of forced expiratory volume in 1 s (FEV1) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations might vary across populations is unknown.

METHODS: In this international, community-based cohort study, we prospectively enrolled adults aged 35-70 years who had no intention of moving residences for 4 years from rural and urban communities across 17 countries. A portable spirometer was used to assess FEV1. FEV1 values were standardised within countries for height, age, and sex, and expressed as a percentage of the country-specific predicted FEV1 value (FEV1%). FEV1% was categorised as no impairment (FEV1% ≥0 SD from country-specific mean), mild impairment (FEV1% <0 SD to -1 SD), moderate impairment (FEV1%

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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