Search tips
Search criteria 


Logo of bmjThe BMJ
BMJ. 1996 September 21; 313(7059): 711–716.
PMCID: PMC2352103

Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study.


OBJECTIVE: To assess the relation between forced expiratory volume in one second (FEV1) and subsequent mortality. DESIGN: Prospective general population study. SETTING: Renfrew and Paisley, Scotland. SUBJECTS: 7058 men and 8353 women aged 45-64 years at baseline screening in 1972-6. MAIN OUTCOME MEASURE: Mortality from all causes, ischaemic heart disease, cancer, hung and other cancers, stroke, respiratory disease, and other causes of death after 15 years of follow up. RESULTS: 2545 men and 1894 women died during the follow up period. Significant trends of increasing risk with diminishing FEV1 are apparent for both sexes for all the causes of death examined after adjustment for age, cigarette smoking, diastolic blood pressure, cholesterol concentration, body mass index, and social class. The relative hazard ratios for all cause mortality for subjects in the lowest fifth of the FEV1 distribution were 1.92 (95% confidence interval 1.68 to 2.20) for men and 1.89 (1.63 to 2.20) for women. Corresponding relative hazard ratios were 1.56 (1.26 to 1.92) and 1.88 (1.44 to 2.47) for ischaemic heart disease, 2.53 (1.69 to 3.79) and 4.37 (1.84 to 10.42) for lung cancer, and 1.66 (1.07 to 2.59) and 1.65 (1.09 to 2.49) for stroke. Reduced FEV1 was also associated with an increased risk for each cause of death examined except cancer for lifelong nonsmokers. CONCLUSIONS: Impaired lung function is a major clinical indicator of mortality risk in men and women for a wide range of diseases. The use of FEV1 as part of any health assessment of middle aged patients should be considered. Smokers with reduced FEV1 should form a priority group for targeted advice to stop smoking.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (993K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Peto R, Speizer FE, Cochrane AL, Moore F, Fletcher CM, Tinker CM, Higgins IT, Gray RG, Richards SM, Gilliland J, et al. The relevance in adults of air-flow obstruction, but not of mucus hypersecretion, to mortality from chronic lung disease. Results from 20 years of prospective observation. Am Rev Respir Dis. 1983 Sep;128(3):491–500. [PubMed]
  • Persson C, Bengtsson C, Lapidus L, Rybo E, Thiringer G, Wedel H. Peak expiratory flow and risk of cardiovascular disease and death. A 12-year follow-up of participants in the population study of women in Gothenburg, Sweden. Am J Epidemiol. 1986 Dec;124(6):942–948. [PubMed]
  • Ebi-Kryston KL. Respiratory symptoms and pulmonary function as predictors of 10-year mortality from respiratory disease, cardiovascular disease, and all causes in the Whitehall Study. J Clin Epidemiol. 1988;41(3):251–260. [PubMed]
  • Cook DG, Shaper AG. Breathlessness, lung function and the risk of heart attack. Eur Heart J. 1988 Nov;9(11):1215–1222. [PubMed]
  • Tockman MS, Comstock GW. Respiratory risk factors and mortality: longitudinal studies in Washington County, Maryland. Am Rev Respir Dis. 1989 Sep;140(3 Pt 2):S56–S63. [PubMed]
  • Welin L, Svärdsudd K, Wilhelmsen L, Larsson B, Tibblin G. Analysis of risk factors for stroke in a cohort of men born in 1913. N Engl J Med. 1987 Aug 27;317(9):521–526. [PubMed]
  • Kuller LH, Ockene J, Meilahn E, Svendsen KH. Relation of forced expiratory volume in one second (FEV1) to lung cancer mortality in the Multiple Risk Factor Intervention Trial (MRFIT). Am J Epidemiol. 1990 Aug;132(2):265–274. [PubMed]
  • Tockman MS, Anthonisen NR, Wright EC, Donithan MG. Airways obstruction and the risk for lung cancer. Ann Intern Med. 1987 Apr;106(4):512–518. [PubMed]
  • Van den Eeden SK, Friedman GD. Forced expiratory volume (1 second) and lung cancer incidence and mortality. Epidemiology. 1992 May;3(3):253–257. [PubMed]
  • Isles CG, Hole DJ, Gillis CR, Hawthorne VM, Lever AF. Plasma cholesterol, coronary heart disease, and cancer in the Renfrew and Paisley survey. BMJ. 1989 Apr 8;298(6678):920–924. [PMC free article] [PubMed]
  • Rose G, Shipley M. Plasma cholesterol concentration and death from coronary heart disease: 10 year results of the Whitehall study. Br Med J (Clin Res Ed) 1986 Aug 2;293(6542):306–307. [PMC free article] [PubMed]
  • Shaper AG, Phillips AN, Pocock SJ. Plasma cholesterol, coronary heart disease, and cancer. BMJ. 1989 May 20;298(6684):a1381–1381. [PMC free article]
  • Ebi-Kryston KL, Hawthorne VM, Rose G, Shipley MJ, Gillis CR, Hole DJ, Carmen W, Eshleman S, Higgins MW. Breathlessness, chronic bronchitis and reduced pulmonary function as predictors of cardiovascular disease mortality among men in England, Scotland and the United States. Int J Epidemiol. 1989 Mar;18(1):84–88. [PubMed]
  • Hawthorne VM, Greaves DA, Beevers DG. Blood pressure in a Scottish town. Br Med J. 1974 Sep 7;3(5931):600–603. [PMC free article] [PubMed]
  • Smith GD, Phillips AN. Confounding in epidemiological studies: why "independent" effects may not be all they seem. BMJ. 1992 Sep 26;305(6856):757–759. [PMC free article] [PubMed]
  • Krzyzanowski M, Wysocki M. The relation of thirteen-year mortality to ventilatory impairment and other respiratory symptoms: the Cracow Study. Int J Epidemiol. 1986 Mar;15(1):56–64. [PubMed]
  • Farchi G, Menotti A, Conti S. Coronary risk factors and survival probability from coronary and other causes of death. Am J Epidemiol. 1987 Sep;126(3):400–408. [PubMed]
  • Browner WS, Du Chene AG, Hulley SB. Effects of the multiple risk factor intervention trial smoking cessation program on pulmonary function. A randomized controlled trial. West J Med. 1992 Nov;157(5):534–538. [PMC free article] [PubMed]
  • Anthonisen NR, Connett JE, Kiley JP, Altose MD, Bailey WC, Buist AS, Conway WA, Jr, Enright PL, Kanner RE, O'Hara P, et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1. The Lung Health Study. JAMA. 1994 Nov 16;272(19):1497–1505. [PubMed]

Articles from The BMJ are provided here courtesy of BMJ Publishing Group