Respiratory symptoms and long-term risk of death from cardiovascular disease, cancer and other causes in Swedish men

Background Depressed respiratory function and respiratory symptoms are asso ciated with impaired survival. The present study was undertaken to assess t he relation between respiratory symptoms and mortality from cardiovascular causes, cancer and all causes in a large population of middle-aged men. Methods Prospective population study of 6442 men aged 51-59 at baseline, fr ee of clinical angina pectoris and prior myocardial infarction. Results During 16 years there were 1804 deaths (786 from cardiovascular dis ease, 608 from cancer, 103 from pulmonary disease and 307 from any other ca use). Men with effort-related breathlessness had increased risk of dying fr om all of the examined diseases. After adjustment for age, smoking habit an d other risk factors, the relative risk (RR) associated with breathlessness of dying from coronary disease was 1.43 (95% CI:1.16-1.77), from stroke 1. 77 (95% CI:1.07-2.93), from any cardiovascular disease 1.48 (95% CI:1.24-1. 76), cancer 1.36 (95% CI:1.11-1.67) and from any cause 1.62 (95% CI:1.44-1. 81). An independent effect of breathlessness on cardiovascular death, cance r death and mortality from all causes was found in life-time non-smokers, a nd also if men with chest pain not considered to be angina were excluded. A n independent effect was also found if all deaths during the first half of the follow-up were excluded. Men with cough and phlegm, without breathlessn ess, also had an elevated risk of dying from cardiovascular disease and can cer, but after adjustment for smoking and other risk factors this was no lo nger significant. However, a slightly elevated independent risk of dying fr om any cause was found (RR = 1.18 [95% CI: 1.02-1.36]). Conclusion A positive response to a simple question about effort related br eathlessness predicted subsequent mortality from several causes during a fo llow-up period of 16 years, independently of smoking and other risk factors .