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Environmental exposures and systemic hypertension are risk factors for decline in lung function

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dc.contributor.author Miele, Catherine H.
dc.contributor.author Grigsby, Matthew R.
dc.contributor.author Siddharthan, Trishul
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Bernabé Ortiz, Antonio
dc.contributor.author Wise, Robert A.
dc.contributor.author Checkley, William
dc.date.accessioned 2018-11-30T03:10:45Z
dc.date.available 2018-11-30T03:10:45Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4055
dc.description.abstract BACKGROUND: Chronic lung disease is a leading contributor to the global disease burden; however, beyond tobacco smoke, we do not fully understand what risk factors contribute to lung function decline in low-income and middle-income countries. METHODS: We collected sociodemographic and clinical data in a randomly selected, age-stratified, sex-stratified and site-stratified population-based sample of 3048 adults aged ≥35 years from four resource-poor settings in Peru. We assessed baseline and annual pre-bronchodilator and post-bronchodilator lung function over 3 years. We used linear mixed-effects models to assess biological, socioeconomic and environmental risk factors associated with accelerated lung function decline. RESULTS: Mean±SD enrolment age was 55.4±12.5 years, 49.2% were male and mean follow-up time was 2.36 (SD 0.61) years. Mean annual pre-bronchodilator FEV1 decline was 30.3 mL/year (95% CI 28.6 to 32.0) and pre-bronchodilator FVC decline was 32.2 mL/year (30.0 to 34.4). Using multivariable linear mixed-effects regression, we found that urban living, high-altitude dwelling and having hypertension accounted for 25.9% (95% CI 15.7% to 36.1%), 21.3% (11.1% to 31.5%) and 15.7% (3.7% to 26.9%) of the overall mean annual decline in pre-bronchodilator FEV1/height2, respectively. Corresponding estimates for pre-bronchodilator FVC/height2 were 42.1% (95% CI% 29.8% to 54.4%), 36.0% (23.7% to 48.2%) and 15.8% (2.6% to 28.9%) of the overall mean annual decline, respectively. CONCLUSION: Urbanisation, living at high altitude and hypertension were associated with accelerated lung function decline in a population with low daily smoking prevalence. en_US
dc.language.iso eng
dc.publisher BMJ Publishing Group
dc.relation.ispartofseries Thorax
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject copd epidemiology en_US
dc.subject not applicable en_US
dc.subject tobacco and the lung en_US
dc.title Environmental exposures and systemic hypertension are risk factors for decline in lung function en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1136/thoraxjnl-2017-210477
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.07
dc.relation.issn 1468-3296


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