Asymptomatic leg and carotid atherosclerosis in smokers is related to degree of ventilatory capacity - Longitudinal and cross-sectional results from 'Men born in 1914', Sweden

Although smoking is associated with cardiovascular disease (CVD), many indi viduals remain healthy after many years of smoking. The population based co hort 'Men born in 1914' was used to investigate whether the occurrence of n on-invasively detected atherosclerosis among smokers is associated with lun g function [(i.e. height-adjusted forced expiratory volume during 1 s (FEV1 .0) and vital capacity (VC)]. Two hundred and seven smokers without history of CVD were examined with spirometry and calf plethysmography at 55 years, and with spirometry, ankle-arm blood pressure recordings and ultrasound ex aminations of the carotid arteries at 68 years. Eighty-three men had athero sclerosis defined as carotid stenosis > 30% or ankle-arm index <0.9. FEV1.0 and VC were both at 55 years (longitudinally) and at 68 years (cross-secti onally) lower among men with atherosclerosis at 68 years (55 years: FEV1.0, 3.2 +/- 0.6 vs. 3.4 +/- 0.51; P = 0.02; VC, 4.2 +/- 0.5 vs. 4.4 +/- 0.5 1; P = 0.02; 68 years: FEV1.0, 2.6 +/- 0.6 vs. 2.9 +/- 0.7 1; P = 0.004; VC, 3.8 +/- 0.6 vs. 4.0 +/- 0.6; P = 0.009, for men with and without atheroscle rosis). The longitudinal and cross-sectional associations between FEV1.0, V C and atherosclerosis remained significant after adjustments for several po tential confounders (tobacco consumption at 55 and 68 years, hypertension, diabetes, alcohol consumption at 68 years, and pulse wave amplitude as a me asure of degree of atherosclerosis at 55 years). We conclude that the risk of developing atherosclerosis is associated with the degree of ventilatory capacity. The results suggest that in smokers, reduced lung function is a m arker of susceptibility for atherosclerosis. (C) 2001 Elsevier Science Irel and Ltd. All rights reserved.