IMPAIRED LUNG-FUNCTION AND MORTALITY RISK IN MEN AND WOMEN - FINDINGSFROM THE RENFREW AND PAISLEY PROSPECTIVE POPULATION STUDY

Objective-To assess the relation between forced expiratory volume in o ne second (FEV(1)) and subsequent mortality. Design-Prospective genera l population study. Setting-Renfrew and Paisley, Scotland. Subjects-70 58 men and 8353 women aged 45-64 years at baseline screening in 1972-6 . Main outcome measure-Mortality from all causes, ischaemic heart dise ase, cancer, lung and other cancers, stroke, respiratory disease, and other causes of death after 15 years of follow up. Results-2545 men an d 1894 women died during the follow up period. Significant trends of i ncreasing risk with diminishing FEV(1) are apparent for both sexes for all the causes of death examined after adjustment for age, cigarette smoking, diastolic blood pressure, cholesterol concentration, body mas s index, and social class. The relative hazard ratios for all cause mo rtality for subjects in the lowest fifth of the FEV(1) distribution we re 1.92 (95% confidence interval 1.68 to 2.20) for men and 1.89 (1.63 to 2.20) for women. Corresponding relative hazard ratios were 1.56 (1. 26 to 1.92) and 1.88 (1.44 to 2.47) for ischaemic heart disease, 2.53 (1.69 to 3.79) and 4.37 (1.84 to 10.42) for lung cancer, and 1.66 (1.0 7 to 2.59) and 1.65 (1.09 to 2.49) for stroke. Reduced FEV(1) was also associated with an increased risk for each cause of death examined ex cept cancer for lifelong nonsmokers. Conclusions-Impaired lung functio n is major clinical indicator of mortality risk in men and women for a wide range of diseases. The use of FEV(1) as part of any health asses sment of middle aged patients should be considered. Smokers with reduc ed FEV(1) should form a priority group for targeted advice to stop smo king.