Associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly First Nations population: a cohort study.
Summary: Background: Spirometric lung function impairment is an independent predictor of respiratory and cardiovascular disease, and mortality across a broad range of socioeconomic backgrounds and environmental settings. No contemporary studies have explored these relationships in a predominantly re...
Published in: | The Lancet Regional Health - Western Pacific |
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ftdoajarticles:oai:doaj.org/article:d95df04673874603b995bece8e2a7ab3 2023-05-15T16:14:06+02:00 Associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly First Nations population: a cohort study. Andrew J Collaro Anne B Chang Julie M Marchant Mark D Chatfield Annette Dent Tamara Blake Patsi Mawn Kwun Fong Margaret S McElrea 2021-08-01T00:00:00Z https://doi.org/10.1016/j.lanwpc.2021.100188 https://doaj.org/article/d95df04673874603b995bece8e2a7ab3 EN eng Elsevier http://www.sciencedirect.com/science/article/pii/S2666606521000973 https://doaj.org/toc/2666-6065 2666-6065 doi:10.1016/j.lanwpc.2021.100188 https://doaj.org/article/d95df04673874603b995bece8e2a7ab3 The Lancet Regional Health. Western Pacific, Vol 13, Iss , Pp 100188- (2021) Respiratory Medicine First Nations Cardiovascular Disease lung function spirometry Outcomes Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1016/j.lanwpc.2021.100188 2022-12-31T06:57:34Z Summary: Background: Spirometric lung function impairment is an independent predictor of respiratory and cardiovascular disease, and mortality across a broad range of socioeconomic backgrounds and environmental settings. No contemporary studies have explored these relationships in a predominantly regional/remote First Nations population, whose health outcomes are worse than for non-First Nations populations, and First Nations people living in urban centres. Methods: This was a retrospective cohort study of 1,734 adults (1,113 First Nations) referred to specialist respiratory outreach clinics in the state of Queensland, Australia from February 2012 to March 2020. Regression modelling was used to test associations between lung function and mortality and cardiovascular disease. Findings: At the time of analysis (August 2020), 189 patients had died: 88 (47%) from respiratory causes and 38 (20%) from cardiovascular causes. When compared to patients with forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) Z-scores of >0 to -1, patients with Z-scores <-1 were at elevated mortality risk (HR=3•2, 95%CI 1•4-7•4; HR=2•6, 95%CI 1•3-5•1), and elevated cardiovascular disease risk (OR=1•5, 95%CI 1•1-2•2; OR=1•6, 95%CI 1•2-2•3). FEV1/FVC% Z-scores <-1 were associated with increased overall mortality (HR=1•6, 95%CI 1•1-2•3), but not cardiovascular disease (OR=1•1, 95%CI 0•8-1•4). These associations were not affected by First Nations status. Interpretation: Reduced lung function even within the clinically normal range is associated with increased mortality, and cardiovascular disease in First Nations Australians. These findings highlight the importance of lung function optimisation and inform the need for future investment to improve outcomes in First Nations populations. Funding: None. Article in Journal/Newspaper First Nations Directory of Open Access Journals: DOAJ Articles Queensland The Lancet Regional Health - Western Pacific 13 100188 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Respiratory Medicine First Nations Cardiovascular Disease lung function spirometry Outcomes Public aspects of medicine RA1-1270 |
spellingShingle |
Respiratory Medicine First Nations Cardiovascular Disease lung function spirometry Outcomes Public aspects of medicine RA1-1270 Andrew J Collaro Anne B Chang Julie M Marchant Mark D Chatfield Annette Dent Tamara Blake Patsi Mawn Kwun Fong Margaret S McElrea Associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly First Nations population: a cohort study. |
topic_facet |
Respiratory Medicine First Nations Cardiovascular Disease lung function spirometry Outcomes Public aspects of medicine RA1-1270 |
description |
Summary: Background: Spirometric lung function impairment is an independent predictor of respiratory and cardiovascular disease, and mortality across a broad range of socioeconomic backgrounds and environmental settings. No contemporary studies have explored these relationships in a predominantly regional/remote First Nations population, whose health outcomes are worse than for non-First Nations populations, and First Nations people living in urban centres. Methods: This was a retrospective cohort study of 1,734 adults (1,113 First Nations) referred to specialist respiratory outreach clinics in the state of Queensland, Australia from February 2012 to March 2020. Regression modelling was used to test associations between lung function and mortality and cardiovascular disease. Findings: At the time of analysis (August 2020), 189 patients had died: 88 (47%) from respiratory causes and 38 (20%) from cardiovascular causes. When compared to patients with forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) Z-scores of >0 to -1, patients with Z-scores <-1 were at elevated mortality risk (HR=3•2, 95%CI 1•4-7•4; HR=2•6, 95%CI 1•3-5•1), and elevated cardiovascular disease risk (OR=1•5, 95%CI 1•1-2•2; OR=1•6, 95%CI 1•2-2•3). FEV1/FVC% Z-scores <-1 were associated with increased overall mortality (HR=1•6, 95%CI 1•1-2•3), but not cardiovascular disease (OR=1•1, 95%CI 0•8-1•4). These associations were not affected by First Nations status. Interpretation: Reduced lung function even within the clinically normal range is associated with increased mortality, and cardiovascular disease in First Nations Australians. These findings highlight the importance of lung function optimisation and inform the need for future investment to improve outcomes in First Nations populations. Funding: None. |
format |
Article in Journal/Newspaper |
author |
Andrew J Collaro Anne B Chang Julie M Marchant Mark D Chatfield Annette Dent Tamara Blake Patsi Mawn Kwun Fong Margaret S McElrea |
author_facet |
Andrew J Collaro Anne B Chang Julie M Marchant Mark D Chatfield Annette Dent Tamara Blake Patsi Mawn Kwun Fong Margaret S McElrea |
author_sort |
Andrew J Collaro |
title |
Associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly First Nations population: a cohort study. |
title_short |
Associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly First Nations population: a cohort study. |
title_full |
Associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly First Nations population: a cohort study. |
title_fullStr |
Associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly First Nations population: a cohort study. |
title_full_unstemmed |
Associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly First Nations population: a cohort study. |
title_sort |
associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly first nations population: a cohort study. |
publisher |
Elsevier |
publishDate |
2021 |
url |
https://doi.org/10.1016/j.lanwpc.2021.100188 https://doaj.org/article/d95df04673874603b995bece8e2a7ab3 |
geographic |
Queensland |
geographic_facet |
Queensland |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
The Lancet Regional Health. Western Pacific, Vol 13, Iss , Pp 100188- (2021) |
op_relation |
http://www.sciencedirect.com/science/article/pii/S2666606521000973 https://doaj.org/toc/2666-6065 2666-6065 doi:10.1016/j.lanwpc.2021.100188 https://doaj.org/article/d95df04673874603b995bece8e2a7ab3 |
op_doi |
https://doi.org/10.1016/j.lanwpc.2021.100188 |
container_title |
The Lancet Regional Health - Western Pacific |
container_volume |
13 |
container_start_page |
100188 |
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1765999945257582592 |