Respiratory muscle strength and the risk of incident cardiovascular events

• Published in: Thorax Vol. 59; no. 12; pp. 1063 - 1067
• Main Authors: van der Palen, J, Rea, T D, Manolio, T A, Lumley, T, Newman, A B, Tracy, R P, Enright, P L, Psaty, B M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Thoracic Society 01.12.2004; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood pressure; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; CHF; Chronic illnesses; Chronic obstructive pulmonary disease; congestive heart failure; CVD; Family medical history; Female; FEV1; Follow-Up Studies; Forced Expiratory Volume - physiology; forced expiratory volume in 1 second; forced vital capacity; FVC; Health risk assessment; Heart attacks; Hospitals; Humans; Inflammation; Laboratories; Male; maximal inspiratory pressure; Maximal Voluntary Ventilation - physiology; Medical sciences; Mens health; Metabolism; MIP; Morbidity; Mortality; myocardial infarction; Older people; Oxidative stress; Pneumology; Prospective Studies; residual volume; Respiratory Muscles; Respiratory Muscles - physiology; Risk Factors; stroke; Studies; Vital Capacity - physiology; Womens health; Vascular disease; Respiratory muscle; Respiratory disease; Atherosclerosis; Risk factor; Cardiovascular disease; Strength
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thx.2004.021915

Background: Maximal inspiratory pressure (MIP) is a measure of inspiratory muscle strength. The prognostic importance of MIP for cardiovascular events among elderly community dwelling individuals is unknown. Diminished forced vital capacity (FVC) is a risk factor for cardiovascular events which remains largely unexplained. Methods: MIP was measured at the baseline examination of the Cardiovascular Health Study. Participants had to be free of prevalent congestive heart failure (CHF), myocardial infarction (MI), and stroke. Results: Subjects in the lowest quintile of MIP had a 1.5-fold increased risk of MI (HR 1.48, 95% CI 1.07 to 2.06) and cardiovascular disease (CVD) death (HR 1.54, 95% CI 1.09 to 2.15) after adjustment for non-pulmonary function covariates. There was a potential inverse relationship with stroke (HR 1.36, 95% CI 0.97 to 1.90), but there was little evidence of an association between MIP and CHF (HR 1.22, 95% CI 0.93 to 1.60). The addition of FVC to models attenuated the HR associated with MIP only modestly; similarly, addition of MIP attenuated the HR associated with FVC only modestly. Conclusions: A reduced MIP is an independent risk factor for MI and CVD death, and a suggestion of an increased risk for stroke. This association with MIP appeared to be mediated through mechanisms other than inflammation.