REDUCED VITAL CAPACITY IN ELDERLY PERSONS WITH HYPERTENSION, CORONARY-HEART-DISEASE, OR LEFT-VENTRICULAR HYPERTROPHY - THE CARDIOVASCULAR HEALTH STUDY

The Cardiovascular Health Study provided the opportunity to determine the association of subclinical and clinical cardiovascular disease wit h pulmonary function in a population sample of elderly adults. Include d were 2,955 women and 2,246 men over age 64 years who were recruited for this observational study from four communities and completed exten sive examinations that included spirometry, echocardiograms, and blood pressure. Current smokers, past smokers with >20 pack-years of smokin g, and persons with a history of asthma, chronic bronchitis, or emphys ema were excluded from this analysis, leaving 2,784 (55%) of the cohor t. Systolic hypertension or coronary artery disease was associated wit h 40- to 100-mL decrements in FEV(1) and 50- to 150-mL decrements in F VC, while a history of congestive heart failure was associated with 20 0 to 300 mL lower FEV(1) and FVC values (p<0.0001), after correcting f or age, height, and waist size. Higher left ventricular (LV) mass was also significantly associated with a decrease in FEV(1) and FVC in mul tivariate models. This relationship was strongest with the end-diastol ic LV posterior wall thickness component of LV mass. In summary, FEV(1 ) and FVC are reduced in elderly persons with hypertension, ischemic h eart disease, higher LV mass, and congestive heart failure, though the magnitude of these associations is relatively small unless heart fail ure supervenes. Substantial decrements in percent predicted FEV(1) and FVC should not be attributed to the presence of uncomplicated ischemi c heart disease or hypertension alone.