This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (59)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

The Cardiovascular Health Study

Millicent W. Higgins, MD; Paul L. Enright, MD; Richard A. Kronmal, PhD; Marc B. Schenker, MD; Hoda Anton-Culver, PhD; Mary Lyles, MD; the Cardiovascular Health Study Research Group; L. Burke Gregory, MD, MS; R. Gale Cruise; Walter H. Ettinger, MD; Alan Elster, MD; Curt D. Furberg, MD, PhD; Barbara Goldsmith; Edward Haponik, MD; Gerardo Heiss, MD; H. Sidney Klopfenstein, MD; David S. Lefkowitz, MD; Mary F. Lyles, MD; Maurice B. Mittelmark, PhD; Ward Riley, PhD; Grethe S. Tell, PhD, MPH; James F. Toole, MD; William Bommer, MD; Marshall Lee, MD; John Robbins, MD, MHS; Marc B. Schenker, MD; R. Nick Bryan, MD, PhD; Trudy L. Bush, PhD, MHS; Joyce Chabot; George W. Comstock, MD, DrPH; Linda P. Fried, MD, MPH; Pearl S. German, ScD; Joel Hill, MS; Steven J. Kittner, MD, MPH; Shiriki Kumanyika, PhD, MPH; Neil R. Powe, MD, MPH, MBA; Thomas R. Price, MD; Robert Rock, MD; Moyses Szklo, MD, DrPH; Janet Bonk, MPH; Julie Thompson-Dobkin, DO; Diane G. Ives, MPH; Charles A. Jungreis, MD; Lewis H. Kuller, MD, DPH; Robert H. McDonald, Jr, MD, PhD; Elaine Meilahn, DrPH; Peg Meyer, MS; Anne Newman, MD; Gale H. Rutan, MD, MPH; Richard Schulz, PhD; Vivienne E. Smith, MD; Sidney K. Wolfson, MD; Hoda Anton-Culver, PhD; Julius M. Gardin, MD; Margaret Knoll; Tom Kurosaki; Nathan Wong, PhD; Daniel H. O'Leary, MD; Joseph F. Polak, MD; Laurie Funk, MS; Edwin Bovill, MD; Elaine Cornell; Paula Howard, MS; Russell P. Tracy, PhD; Paul Enright, MD; Sheila Toogood, Md; Kris Calhoun; Harry Calhoun, PhD; Brent Feser; Farida Rautaharju, MA; Pentti Rautaharju, MD, PhD; Nemat O. Borhani, MD; Annette L. Fitzpatrick, MA; Bonnie K. Hermanson, MS; Richard A. Kronmal, PhD; Bruce M. Psaty, MD, PhD; David S. Siscovick, MD, MPH; Lynn Shemanski, PhD; Patricia W. Wahl, PhD; Diane E. Bild, MD, MPH; Teri A. Manolio, MD, MHS; Peter J. Savage, MD; Patricia Smith

JAMA. 1993;269(21):2741-2748.

Abstract
Objective.
—To investigate relationships between cigarette smoking and pulmonary function in elderly men and women.

Design.
—Cross-sectional analysis of baseline data from a prospective, population-based study of risk factors, preclinical, and overt cardiovascular and pulmonary disease.

Setting.
—Defined communities in Forsyth County, North Carolina; Pittsburgh, Pa; Sacramento County, California; and Washington County, Maryland.

Population.
—A total of 5201 noninstitutionalized men and women 65 years of age and older.

Main Outcome Measures.
—Pulmonary function; means of forced expiratory volume in 1 second (FEV₁) and forced vital capacity and prevalence of low FEV₁ levels.

Results.
—Prevalence of cigarette smoking was 10% to 20% and higher in women than men and in blacks than whites. Forced vital capacity and FEV₁ levels were related positively to height and white race and negatively to age and waist girth. Age- and height-adjusted FEV₁ means were 23% and 18% lower in male and female current smokers, respectively, than in never smokers but not reduced in never smokers currently living with a smoker. Smokers who quit before age 40 years had FEV₁ levels similar to never smokers, but FEV₁ levels were lower by 7% and 14% in smokers who quit at ages 40 to 60 years and older than 60 years, respectively. Lung function was related inversely to pack-years of cigarette use. Prevalence rates of impaired lung function were highest in current smokers and lowest in never smokers. Regression coefficients for the smoking variables were smaller in persons without cardiovascular or respiratory conditions than in the total cohort.

Conclusions.
—Cigarette smoking is associated with reduced pulmonary function in elderly men and women. However, smokers who quit, even after age 60 years, have better pulmonary function than continuing smokers.

(JAMA. 1993;269:2741-2748)

Author Affiliations
Forsyth County, North Carolina—The Bowman Gray School of Medicine of Wake Forest University; Sacramento County—University of California, Davis; Washington County, Maryland—The Johns Hopkins University; Allegheny County, Pennsylvania—University of Pittsburgh; Echocardiography Reading Center—University of California, Irvine; Ultrasound Reading Center—Geisinger Medical Center, Danville, Pa; Central Blood Analysis Laboratory—University of Vermont, Burlington; Pulmonary Function Reading Center—Mayo Clinic and Foundation, Rochester, Minn; Electrocardiography Reading Center—University of Alberta, Edmonton; Coordinating Center—University of Washington, Seattle; National Heart, Lung, and Blood Institute Project Office, Bethesda, Md

From the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (Dr Higgins), Respiratory Sciences Center, University of Arizona, Tucson (Dr Enright), Cardiovascular Health Study Coordinating Center, Seattle, Wash (Dr Kronmal), California College of Medicine, University of California, Irvine (Dr Anton-Culver), Division of Occupational and Environmental Medicine, University of California, Davis (Dr Schenker), and Department of Geriatric Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC (Dr Lyles).

Footnotes
A complete list of the participants in this research study appears at the end of this article.

Reprint requests to National Institutes of Health, National Heart, Lung, and Blood Institute, Federal Bldg, Room 2C08, 7550 Wisconsin Ave, Bethesda, MD 20892 (Dr Higgins).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Physiologic Index of Comorbidity: Relationship to Mortality and Disability
Newman et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2008;63:603-609.
ABSTRACT | FULL TEXT  

Adverse Effects of Smoking on Respiratory Function in Young Adults Born Weighing Less Than 1000 Grams
Doyle et al.
Pediatrics 2003;112:565-569.
ABSTRACT | FULL TEXT  

Environmental tobacco smoke and health in the elderly
Jaakkola
Eur Respir J 2002;19:172-181.
ABSTRACT | FULL TEXT  

Helping Our Clients With Smoking Cessation
Cataldo and Talley
J Am Psychiatr Nurses Assoc 2001;7:26-31.
 

The Prevalence of COPD : Using Smoking Rates to Estimate Disease Frequency in the General Population
Stang et al.
Chest 2000;117 :354S-359S.
ABSTRACT | FULL TEXT  

Pulmonary Function Testing in Population-Based Studies
MANOLIO et al.
Am. J. Respir. Crit. Care Med. 1997;156:1004-1010.
ABSTRACT | FULL TEXT  

Eleven Worthy Aims for Clinical Leadership of Health System Reform
Berwick
JAMA 1994;272:797-802.
ABSTRACT  

Geriatric Medicine
Heuser and Hazzard
JAMA 1994;271:1675-1677.
ABSTRACT  

Use of Transdermal Nicotine in a State-Level Prescription Plan for the Elderly: A First Look at 'Real-World' Patch Users
Orleans et al.
JAMA 1994;271:601-607.
ABSTRACT  

SMOKING CESSATION IS BENEFICIAL AT ANY AGE
JWatch General 1993;1993:4-4.
FULL TEXT  

It's Never Too Late to Stop Smoking But How Old Are Your Lungs?
Petty
JAMA 1993;269:2785-2785.
ABSTRACT