Mortality of asthma, COPD, and asthma-COPD overlap during an 18-year follow up

Tiina Mattila; Tuula Vasankari; Paula Kauppi; Witold Mazur; Tommi Härkänen; Markku Heliövaara

doi:10.1016/j.rmed.2022.107112

Mortality of asthma, COPD, and asthma-COPD overlap during an 18-year follow up

Respir Med. 2023 Feb:207:107112. doi: 10.1016/j.rmed.2022.107112. Epub 2022 Dec 31.

Authors

Tiina Mattila¹, Tuula Vasankari², Paula Kauppi³, Witold Mazur³, Tommi Härkänen⁴, Markku Heliövaara⁴

Affiliations

¹ Department of Pulmonary Diseases, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Meilahti Triangle Hospital, 6th Floor, PO Box 372, 00029 HUS, Helsinki, Finland; National Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland. Electronic address: tiina.m.mattila@hus.fi.
² University of Turku, Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, PO Box 52 (Hämeentie 11), 20521, Turku, Finland; Finnish Lung Health Association (FILHA), Filha ry, Sibeliuksenkatu 11 A 1, 00250, Helsinki, Finland.
³ Department of Pulmonary Diseases, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Meilahti Triangle Hospital, 6th Floor, PO Box 372, 00029 HUS, Helsinki, Finland.
⁴ National Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland.

PMID: 36596385
DOI: 10.1016/j.rmed.2022.107112

Abstract

Background: We studied asthma, COPD, and asthma-COPD overlap (ACO) to predict mortality in a cohort of Finnish adults with an 18-year follow up.

Methods: A national health examination survey representing Finnish adults aged ≥30 years was performed in 2000-2001. The study cohort included 5922 participants (73.8% of the sample) with all relevant data, including a comprehensive clinical examination and spirometry. These participants were followed continuously from baseline until end of 2018 for total, cardiovascular, cancer, and respiratory mortality through a record linkage. Asthma, COPD, and ACO were defined based on the survey data, including spirometry and register data. There were three separate groups of obstructive subjects (one definition excluding the others).

Results: Asthma and COPD were significantly associated with higher total mortality in Cox's model adjusted for sex, age, smoking, education level, BMI, leisure time physical activity, cardiovascular disease, diabetes, and hypertension. Hazard ratios (HR) (95% confidence interval [CI]) for asthma, COPD, and ACO were 1.29 (1.05-1.58), 1.50 (1.20-1.88), and 1.26 (0.97-1.65), respectively. Additionally, asthma (HR 1.47, 95% CI 1.09-1.97) and COPD (HR 1.53, 95% CI 1.08-2.16) were associated with cardiovascular mortality. Although ACO did not predict mortality in the whole cohort, there was a significant association with mortality risk among those with hs-CRP 1-2.99 mg/l.

Conclusions: Asthma or COPD predicts higher total mortality and premature death from cardiovascular diseases.

Keywords: And ACO; Asthma; COPD; Mortality; National health survey.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Asthma*
Cardiovascular Diseases*
Diabetes Mellitus*
Finland
Follow-Up Studies
Humans
Lung
Pulmonary Disease, Chronic Obstructive*