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 r...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-08-01
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| Series: | The Lancet Regional Health. Western Pacific |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606521000973 |
| _version_ | 1818665712883859456 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-17T05:53:00Z |
| format | Article |
| id | doaj.art-d95df04673874603b995bece8e2a7ab3 |
| institution | Directory Open Access Journal |
| issn | 2666-6065 |
| language | English |
| last_indexed | 2024-12-17T05:53:00Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj.art-d95df04673874603b995bece8e2a7ab32022-12-21T22:01:07ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652021-08-0113100188Associations between lung function and future cardiovascular morbidity and overall mortality in a predominantly First Nations population: a cohort study.Andrew J Collaro0Anne B Chang1Julie M Marchant2Mark D Chatfield3Annette Dent4Tamara Blake5Patsi Mawn6Kwun Fong7Margaret S McElrea8Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia; Corresponding author: Mr. Andrew Collaro, Queensland Children's Hospital, Department of Respiratory and Sleep Medicine, Level 5a, 501 Stanley St, South Brisbane, QLD 4101, AUSTRALIAAustralian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia; Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Indigenous Respiratory Outreach Care, The Prince Charles Hospital, Brisbane, Queensland, AustraliaAustralian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, AustraliaChild Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, AustraliaIndigenous Respiratory Outreach Care, The Prince Charles Hospital, Brisbane, Queensland, Australia; Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, AustraliaDepartment of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, AustraliaIndigenous Respiratory Outreach Care, The Prince Charles Hospital, Brisbane, Queensland, AustraliaIndigenous Respiratory Outreach Care, The Prince Charles Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, AustraliaAustralian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia; Indigenous Respiratory Outreach Care, The Prince Charles Hospital, Brisbane, Queensland, AustraliaSummary: 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.http://www.sciencedirect.com/science/article/pii/S2666606521000973Respiratory MedicineFirst NationsCardiovascular Diseaselung functionspirometryOutcomes |
| spellingShingle | 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. The Lancet Regional Health. Western Pacific Respiratory Medicine First Nations Cardiovascular Disease lung function spirometry Outcomes |
| title | 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_short | 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 |
| topic | Respiratory Medicine First Nations Cardiovascular Disease lung function spirometry Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2666606521000973 |
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