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Clinical Trial
. 2019 Mar 18;14(3):e0214083.
doi: 10.1371/journal.pone.0214083. eCollection 2019.

Breathlessness and incidence of COPD, cardiac events and all-cause mortality: A 44-year follow-up from middle age throughout life

Jacob Sandberg  1 , Gunnar Engström  2 , Magnus Ekström  1
Affiliations
Clinical Trial

Breathlessness and incidence of COPD, cardiac events and all-cause mortality: A 44-year follow-up from middle age throughout life

Jacob Sandberg et al. PLoS One. .

Abstract

Background: Breathlessness is prevalent in the general population and may be associated with adverse health outcomes. This study aimed to evaluate the association of breathlessness with Chronic Obstructive Pulmonary Disease (COPD) events, cardiac events and all-cause mortality from middle-age throughout life.

Methods: Breathlessness was measured in 699, 55-year old men residing in Malmö, Sweden using modified Medical Research Council (mMRC). COPD events (hospitalisation, death or diagnosis) cardiac events and all-cause mortality was assessed using The Swedish Causes of Death Register and Hospital Discharge Register. Data was analyzed using Cox- and competing risks (Fine-Gray) regression analysis.

Results: 695 (99%) of 699 participants died and four emigrated during follow up. Eighty-seven (12%) had mMRC = 1 and 19 (3%) had mMRC≥2. Breathlessness was associated with COPD events; adjusted Sub-Hazard Ratio 2.1 (95% CI, 1.2-3.6) for mMRC = 1 and 7.5 (2.6-21.7) for mMRC ≥ 2 but not associated with cardiac events when adjusting for competing events and confounding. Breathlessness was associated increased all- cause mortality (Hazard Ratios of 1.4 (1.1-1.7) (mMRC = 1) and 3.4 (2.1-5.6) (mMRC ≥ 2)).

Conclusion: Breathlessness is associated with increased risk of COPD events and increase in all-cause mortality from age 55 until death.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Risk of chronic obstructive pulmonary disease (COPD) events (hospitalisation, out-clinic diagnosis or diagnosis from death-certificate) per modified Medical Research Council (mMRC) grade from age 55 throughout life.
Calculated using competing risks regression.
Fig 2
Fig 2. Risk of cardiac events (hospitalisation or death certificates) per modified Medical Research Council (mMRC) grade from age 55 throughout life.
Calculated using competing risk regression.
Fig 3
Fig 3. All-cause mortality per modified Medical Research Council (mMRC) grade from age 55 and throughout life.
P-values were calculated using log rank tests.
See this image and copyright information in PMC

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