Statin Use Reduces Decline in Lung Function: VA Normative Aging Study

• Published in: American journal of respiratory and critical care medicine Vol. 176; no. 8; pp. 742 - 747
• Main Authors: Alexeeff, Stacey E, Litonjua, Augusto A, Sparrow, David, Vokonas, Pantel S, Schwartz, Joel
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 15.10.2007; American Lung Association; American Thoracic Society
• Subjects: Adult; Aged; Aged, 80 and over; Aging; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Asthma; B. Chronic Obstructive Pulmonary Disease; Biological and medical sciences; Bronchitis; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease, asthma; Emergency and intensive respiratory care; Forced Expiratory Volume - drug effects; Forced Expiratory Volume - physiology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Inflammation; Intensive care medicine; Longitudinal Studies; Male; Medical sciences; Medical screening; Middle Aged; Mortality; Oxidative stress; Pneumology; Questionnaires; Smoking; Smoking - epidemiology; Smoking - physiopathology; Statins; Vital Capacity - drug effects; Vital Capacity - physiology; Intensive care; Senescence; FVC; Lung function; statins; Tobacco smoking; smoking; Statin derivative; FEV1; Resuscitation; Antilipemic agent
• DOI: 10.1164/rccm.200705-656OC
• ISSN: 1073-449X

Decreased lung function has been linked to increased inflammation and oxidative stress. Statins have demonstrated antiinflammatory and antioxidant properties. We investigated the effect of statin use on decline in lung function in the elderly, and whether smoking modified this effect. Our study population included 2,136 measurements on 803 elderly men from the Normative Aging Study whose lung function (FVC and FEV(1)) was measured two to four times between 1995 and 2005. Subjects indicated statin use and smoking history at each visit. We used mixed linear models to estimate the effects of each covariate, adjusting for subject and possible confounders. For those not using statins, the estimated decline in FEV(1) was 23.9 ml/year (95% confidence interval [CI], -27.8 to -20.1 ml/yr), whereas those taking statins had an estimated 10.9-ml/year decline in FEV(1) (95% CI, -16.9 to -5.0 ml/yr). We also examined the effect of statins with smoking by dividing the cohort into four groups: never-smokers, longtime quitters (quit >or= 10 yr ago), recent quitters (quit < 10 yr ago), and current smokers. We found a significant three-way interaction between time since first visit, statin use, and smoking status (P < 0.001). Within each smoking category, the effect of statins was always estimated to be beneficial, but the size of the improvement in the decline rate varied among smoking groups. We found similar results for FVC decline. Our results indicate that statin use attenuates decline in lung function in the elderly, with the size of the beneficial effect modified by smoking status.