Chronic respiratory symptoms in young adulthood increase risk for later-life CVD, mortality

Chronic respiratory symptoms in young adulthood were associated with increased risk for cardiovascular disease and all-cause mortality in midlife, independent of CV risk factors, smoking and lung function, researchers reported in Chest.

“Little evidence currently exists regarding the association between chronic respiratory symptoms in young adulthood and cardiovascular outcomes in midlife,” Weijing Feng, MD, PhD, from the department of cardiology at the State Key Laboratory of Organ Failure Research at Guangdong Provincial Key Lab of Shock and Microcirculation at Nanfang Hospital in Guangzhou, China, and colleagues wrote. “Furthermore, identifying the contribution of chronic respiratory symptoms early in life, prior to the onset of CVD and related risk factors, may inform our understanding of how dysfunction in [the] respiratory system affects long-term CVD progression and prognosis.”

Researchers evaluated 4,621 participants aged 18 to 30 years from the Coronary Artery Risk Development in Young Adults (CARDIA) study. They identified chronic respiratory symptoms using respiratory symptom questionnaires.

During a median follow-up of 30.9 years, 284 incident CVD events and 378 deaths occurred.

In the cohort, 2,525 participants (mean age, 24.8 years; 52.9% women) had no chronic respiratory symptoms in young adulthood, 1,182 (mean age, 25.1 years; 55.2% women) had one, 611 (mean age, 24.9 years; 57.8% women) had two and 303 (mean age, 25.3 years; 63% women) had three or four.

Chronic respiratory symptoms were associated with increased risk for CVD events for any respiratory symptom (HR = 1.51; 95% CI, 1.18-1.93), cough or phlegm (HR = 1.57; 95% CI, 1.18-2.09), wheeze (HR = 1.31; 95% CI, 1.01-1.68), shortness of breath (HR = 1.73; 95% CI, 1.25-2.41) and chest illnesses (HR = 1.32; 95% CI, 1.01-1.71) after adjusting for demographic characteristics, CV risk factors, smoking and lung function.

Researchers observed similar findings for all-cause mortality.

The HR for CVD increased by 97% (HR = 1.97; 95% CI, 1.34-2.91) and all-cause mortality by 75% (HR = 1.75; 95% CI, 1.23-2.47) when researchers compared participants with no chronic respiratory symptoms and those with three or four symptoms.

“[These findings] suggest that identifying chronic respiratory symptoms in young adulthood may help provide prognostic information regarding future cardiovascular health,” the researchers wrote.