Cardiorespiratory fitness does not offset the increased risk of chronic obstructive pulmonary disease attributed to smoking: a cohort study

Setor K Kunutsor*, Sae Young Jae, Timo Mäkikallio, Jari A Laukkanen

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)

Abstract

Though evidence suggests that higher cardiorespiratory fitness (CRF) levels can offset the adverse effects of other risk factors, it is unknown if CRF offsets the increased risk of chronic obstructive pulmonary disease (COPD) due to smoking. We aimed to evaluate the combined effects of smoking status and CRF on incident COPD risk using a prospective cohort of 2,295 middle-aged Finnish men. Peak oxygen uptake, assessed with respiratory gas exchange analyzers, was used as a measure of CRF. Smoking status was self-reported. Cardiorespiratory fitness was categorised as low and high based on median cutoffs, whereas smoking status was classified into smokers and non-smokers. Multivariable-adjusted hazard ratios (HRs) with confidence intervals (CIs) were calculated. During 26 years median follow-up, 119 COPD cases were recorded. Smoking increased COPD risk 10.59 (95% CI: 6.64-16.88), and high CRF levels decreased COPD risk 0.43 (95% CI: 0.25-0.73). Compared with non-smoker-low CRF, smoker-low CRF was associated with an increased COPD risk in multivariable analysis 9.79 (95% CI: 5.61-17.08), with attenuated but persisting evidence of an association for smoker-high CRF and COPD risk 6.10 (95% CI: 3.22-11.57). An additive interaction was found between smoking status and CRF (RERI=6.99). Except for CRF and COPD risk, the associations persisted on accounting for mortality as a competing risk event. Despite a wealth of evidence on the ability of high CRF to offset the adverse effects of other risk factors, it appears high CRF levels have only modest attenuating effects on the very strong association between smoking and COPD risk.
Original languageEnglish
Pages (from-to)423-428
Number of pages6
JournalEuropean Journal of Epidemiology
Volume37
Issue number4
Early online date5 Feb 2022
DOIs
Publication statusPublished - 1 Apr 2022

Keywords

  • smoking
  • cardiorespiratory fitness
  • chronic obstructive pulmonary disease
  • cohort study

Fingerprint

Dive into the research topics of 'Cardiorespiratory fitness does not offset the increased risk of chronic obstructive pulmonary disease attributed to smoking: a cohort study'. Together they form a unique fingerprint.

Cite this