Published ahead of print on August 2, 2007, doi:10.1164/rccm.200705-656OC Am. J. Respir. Crit. Care Med., Volume 176, Number 8, October 2007, 742-747 A more recent version of this article appeared on October 15, 2007
Submitted on May 2, 2007 Statin Use Reduces Decline in Lung Function: VA Normative Aging StudyStacey E Alexeeff1*,1 Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA, 2 Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, 3 Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Normative Aging Study, VA Boston Healthcare System and Department of Medicine, Boston University School of Medicine, Boston, MA, USA, 4 VA Normative Aging Study, VA Boston Healthcare System and Department of Medicine, Boston University School of Medicine, Boston, MA, USA, 5 Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA; Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA * To whom correspondence should be addressed. E-mail: sackerma{at}hsph.harvard.edu.
Background: Decreased lung function has been linked to increased inflammation and oxidative stress. Statins have demonstrated anti-inflammatory 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 (forced vital capacity [FVC] and forced expiratory volume in one second [FEV1]) was measured 2-4 times between 1995-2005. 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.
Results: For those not using statins, the estimated decline in FEV1 was 23.9mL/yr (95% CI: -27.8mL/yr, -20.1mL/yr), while those taking statins had an estimated 10.9mL/yr decline in FEV1 (95% CI: -16.9mL/yr, -5.0mL/yr). We also examined the effect of statins with smoking by dividing the cohort into four groups: never smokers, long-time quitters (quit Key words: statins, lung function, FVC, FEV1, smoking
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10 years ago), recent quitters (quit <10 years ago), and current smokers. We found a significant three-way interaction between time since first visit, statin use, and smoking status (p-value < 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.
