Risk Factors for Chronic Obstructive Pulmonary Disease Mortality in Chinese Adults

• Published in: American journal of epidemiology 2008-04, Vol.167 (8), p.998-1004
• Main Authors: Reilly, Kathleen H., Gu, Dongfeng, Duan, Xiufang, Wu, Xigui, Chen, Chung-Shiuan, Huang, Jianfeng, Kelly, Tanika N., Chen, Jichun, Liu, Xiaoqing, Yu, Ling, Bazzano, Lydia A., He, Jiang
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Analysis. Health state; Asian people; Biological and medical sciences; Body Mass Index; China; China - epidemiology; chronic obstructive; Chronic obstructive pulmonary disease; Confidence Intervals; Educational Status; Epidemiology; Female; General aspects; Health Status; Humans; Male; Medical research; Medical sciences; Middle Aged; Mortality; Motor Activity; prospective studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; pulmonary disease; Pulmonary Disease, Chronic Obstructive - etiology; Pulmonary Disease, Chronic Obstructive - mortality; Risk; Risk Assessment; Risk Factors; Rural Population - statistics & numerical data; Smoking - adverse effects; Smoking - epidemiology; Thinness; Urban Population - statistics & numerical data
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwm393

Chronic obstructive pulmonary disease mortality and risk factors were studied in a nationally representative sample of 169,871 Chinese men and women aged 40 years or older. Baseline data were collected in 1991 by using a standard protocol, and a follow-up evaluation was conducted in 1999–2000, with a response rate of 93.4%. Age-standardized mortality (per 100,000 person-years) was 179.9 for men and 141.3 for women. After adjustment for important covariables, the respective relative risks of chronic obstructive pulmonary disease–related mortality for baseline risk factors in men and women were 2.80 (95% confidence interval (CI): 2.64, 2.98) and 2.71 (95% CI: 2.53, 2.89) for each 10-year increase in age, 0.84 (95% CI: 0.74, 0.95) and 1.44 (95% CI: 1.07, 1.95) for alcohol consumption, 1.18 (95% CI: 1.04, 1.35) and 1.77 (95% CI: 1.45, 2.15) for ≥20 pack-years of smoking, 2.37 (95% CI: 1.91, 2.94) and 2.47 (95% CI: 1.66, 3.67) for non-high-school graduation, 1.57 (95% CI: 1.38, 1.79) and 1.35 (95% CI: 1.17, 1.56) for physical inactivity, 2.66 (95% CI: 2.34, 3.02) and 2.60 (95% CI: 2.25, 3.00) for underweight, 1.39 (95% CI: 1.23, 1.57) and 1.73 (95% CI: 1.50, 2.00) for living in northern China, and 2.14 (95% CI: 1.86, 2.46) and 1.79 (95% CI: 1.55, 2.07) for living in rural China. This study indicated that cigarette smoking, low educational level, physical inactivity, and underweight are important modifiable risk factors for chronic obstructive pulmonary disease–related mortality in China.