Chest
Volume 116, Issue 1, July 1999, Pages 150-156
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Clinical Investigations
Brain/Lung Interaction
Lower Pulmonary Function and Cerebral Subclinical Abnormalities Detected by MRI: The Atherosclerosis Risk in Communities Study

https://doi.org/10.1378/chest.116.1.150Get rights and content

Study objectives

To investigate the association between pulmonary function and (1) cerebral infarction and (2) white matter lesions (WMLs), identified by MRI and believed to represent subclinical lesions of arteriosclerosis, generalized hypoperfusion, or ischemia of the brain.

Design

Population-based, cross-sectional study.

Setting

Two communities in the United States.

Participants

A sample of 1,917 African-American and white men and women 55 to 72 years old who were selected from the second follow-up examination of the Atherosclerosis Risk in Communities Study cohort.

Interventions

Observational study.

Measurements and results

The lung function indexes, FEV1 and FVC, were assessed according to American Thoracic Society criteria. Subclinical cerebral infarction and WMLs were assessed by MRI. After adjusting for age, ethnicity, gender, height, and height squared, a 1-SD decrease of FEV1 in nonsmokers was associated with odds ratios (95% confidence interval [CI], 1.31 to 2.03) of 1.63 for infarction and 1.35 (95% CI, 1.08 to 1.69) for WMLs. Of those in the lowest quartile of FEV1, 15% had infarction and WMLs, in contrast to 6% of the individuals in the uppermost quartile of FEV1. Consistent associations were also observed by using FVC as an index of pulmonary function. Similar patterns of association were found among current smokers. The associations were not altered by additional adjustment of conventional risk factors of cardiovascular disease, comorbidity, or cognitive function.

Conclusion

The results from this population-based study suggest that lower pulmonary function is associated with subclinical cerebral abnormalities.

Section snippets

Materials and Methods

The sample for this report consisted of 1,917 individuals who participated in the cerebral MRI study at two study sites of the Atherosclerosis Risk in Communities (ARIC) study. ARIC is a longitudinal study of cardiovascular and pulmonary diseases sponsored by the National Heart, Lung, and Blood Institute. It includes a community surveillance and a cohort component. The ARIC cohort was selected as a probability sample of 15,800 men and women between the ages of 45 and 64 years old at four study

Results

The mean age of participants was 62 years old; 50% were African Americans, and 40% were men. The characteristics of the sample, both overall and stratified by cerebral abnormality and by the lung function, are presented in Table 1. The profile of cardiovascular and cerebrovascular disease risk factors was similar to that of African-American and European-American men and women of similar age in the full ARIC cohort from the two study sites. When stratified by the presence of cerebrovascular

Discussion

Asymptomatic cerebral infarction and WMLs are considered to be sequelae of arteriosclerosis, cerebral hypoperfusion, or ischemia.1234567891011 The prevalence of infarction was 30% in individuals aged ≥ 65 years old examined by the Cardiovascular Health Study6 and about 15% in our sample of men and women aged≥ 55 years old . The prevalence of WMLs was 27 among 100 individuals ages 65 to 85 years old examined by the Rotterdam Study,1187% in the Cardiovascular Health Study cohort,25 and 85% in the

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