Pulmonary function is a long-term predictor of mortality in the general population: 29-Year follow-up of the Buffalo Health Study

Study objectives: Results from several studies have described a relationship between pulmonary function and both all-cause and cause-specific mortality. The purpose of this study was to investigate the predictive value of pulmonary function by gender after 29 years of follow-up. Design: Prospective study with 29-year follow-up of the Buffalo Health Study cohort. Participants: Randomly selected sample of 554 men and 641 women, aged 20 to 89 years, from all listed households of the city of Buffalo, NY. Measurements and results: Baseline measurements were performed in 1960 to 1961. Pulmonary function was assessed based on FEV₁ expressed as the normal percent predicted (FEV₁%pred). FEV₁%pred adjusted by age, body mass index, systolic BP, education, and smoking status was inversely related to all-cause mortality in both men and women (p < 0.01). A sequential survival analysis in participants who had a survival time of at least 5, 10, 15, 20, and 25 years after enrollment in the study was also performed. Except for men who survived for > 25 years, we observed a statistically significant negative association between FEV₁%pred and all-cause mortality. FEV₁%pred was also inversely related to ischemic heart disease (IHD) mortality. When participants were divided into quintiles of FEV₁%pred, participants in the lowest quintile of FEV₁%pred experienced significantly higher all-cause mortality compared with participants in the highest quintile of FEV₁%pred. For the entire follow-up period, the adjusted hazard ratios for all-cause mortality were 2.24 (95% confidence interval [CI], 1.60 to 3.13) for men and 1.81 (95% CI, 1.24 to 2.63) for women, respectively. Hazard ratios for death from IHD in the lowest quintile of FEV₁%pred were 2.11 (95% CI, 1.20 to 3.71) and 1.96 (95% CI, 0.99 to 3.88) for men and women, respectively. Conclusions: These results suggest that pulmonary function is a long-term predictor for overall survival rates in both genders and could be used as a tool in general health assessment.