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Statin Use Reduces Decline in Lung Function

VA Normative Aging Study

¹ Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts; ² Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and ³ VA Normative Aging Study, VA Boston Healthcare System and Department of Medicine, Boston University School of Medicine, Boston, Massachusetts

Correspondence and requests for reprints should be addressed to Stacey E. Alexeeff, B.Sc., Exposure, Epidemiology, and Risk Program, Harvard School of Public Health, Landmark Center West, 415, 401 Park Drive, Boston, MA 02215. E-mail: sackerma{at}hsph.harvard.edu

Rationale: Decreased lung function has been linked to increased inflammation and oxidative stress. Statins have demonstrated antiinflammatory and antioxidant properties.

Objectives: We investigated the effect of statin use on decline in lung function in the elderly, and whether smoking modified this effect.

Methods: Our study population included 2,136 measurements on 803 elderly men from the Normative Aging Study whose lung function (FVC and FEV₁) was measured two to four times between 1995 and 2005. Subjects indicated statin use and smoking history at each visit. We used mixed linear models to estimate the effects of each covariate, adjusting for subject and possible confounders.

Measurements and Main Results: For those not using statins, the estimated decline in FEV₁ was 23.9 ml/year (95% confidence interval [CI], –27.8 to –20.1 ml/yr), whereas those taking statins had an estimated 10.9-ml/year decline in FEV₁ (95% CI, –16.9 to –5.0 ml/yr). We also examined the effect of statins with smoking by dividing the cohort into four groups: never-smokers, longtime quitters (quit 10 yr ago), recent quitters (quit < 10 yr ago), and current smokers. We found a significant three-way interaction between time since first visit, statin use, and smoking status (P < 0.001). Within each smoking category, the effect of statins was always estimated to be beneficial, but the size of the improvement in the decline rate varied among smoking groups. We found similar results for FVC decline.

Conclusions: Our results indicate that statin use attenuates decline in lung function in the elderly, with the size of the beneficial effect modified by smoking status.

Key Words: statins • lung function • FVC • FEV₁ • smoking

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Inflammation and oxidative stress are associated with decreased lung function. Statins have demonstrated antiinflammatory and antioxidant properties. What This Study Adds to the Field Statin use is associated with slower rates of lung function decline in the elderly. This suggests a possible treatment for those with impaired lung function that should be investigated further.

 

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