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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 H.
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Bernabe-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.ispartof urn:issn:1468-3296
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#3.02.00 es_PE

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